Clinical Utility of Initial Terminal Deoxynucleotidyl Transferase Determinations in Childhood Acute Leukemias

David K. Kalwinsky, William H. Weatherred, Gary V. Dahl, W. Paul Bowman, Susan L. Melvin, Mary Sue Coleman, F. J. Bollum

Research output: Contribution to journalArticle

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Abstract

Terminal deoxynucleotidyl transferase (TDT) activity was measured in bone marrow lymphoblasts obtained at diagnosis from 168 consecutive patients with childhood acute leukemia. Absolute concentrations of TDT were increased (>20 units/108 blasts) in samples from 98 of 112 assessable patients with acute lymphocytic leukemia (ALL). The values ranged from <1 to 1502 units/108 blasts with a median of 90 units contrasted with <1 to 219 units (median, 2.6 units) in studies of children without leukemia. Results of an immunofluorescence assay were in good agreement with enzymatic detection of the polymerase. Among 115 patients with adequate marrow smears, 105 had TDT-positive blasts. By contrast, in most children with acute myelogenous leukemia, TDT activity was either undetectable or less than 10 units/108 blasts. Although the highest levels of TDT were found in blasts with the common ALL phenotype, quantitative determinations were not significantly related to the major immunological subtypes of ALL or to morphological features or periodic acid-Schiff reactivity of the lymphoblasts. The probability that a newly diagnosed case of leukemia would be ALL was 90% if TDT levels were greater than 20 units/108 blasts. We conclude that absolute concentrations of TDT, as determined in this study, are of little value in identifying subclasses of ALL. The immunofluorescence assay, which is much less expensive and easier to perform than the enzyme assay, should prove useful for comfirming the diagnosis of ALL and for detecting extramedullary sites of leukemic infiltration.

Original languageEnglish
Pages (from-to)2877-2881
Number of pages5
JournalCancer Research
Volume41
Issue number7
StatePublished - 1 Jul 1981

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DNA Nucleotidylexotransferase
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Leukemia
Fluorescent Antibody Technique
Bone Marrow
Leukemic Infiltration
Periodic Acid
Enzyme Assays
Acute Myeloid Leukemia
Phenotype

Cite this

Kalwinsky, D. K., Weatherred, W. H., Dahl, G. V., Bowman, W. P., Melvin, S. L., Coleman, M. S., & Bollum, F. J. (1981). Clinical Utility of Initial Terminal Deoxynucleotidyl Transferase Determinations in Childhood Acute Leukemias. Cancer Research, 41(7), 2877-2881.
Kalwinsky, David K. ; Weatherred, William H. ; Dahl, Gary V. ; Bowman, W. Paul ; Melvin, Susan L. ; Coleman, Mary Sue ; Bollum, F. J. / Clinical Utility of Initial Terminal Deoxynucleotidyl Transferase Determinations in Childhood Acute Leukemias. In: Cancer Research. 1981 ; Vol. 41, No. 7. pp. 2877-2881.
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Kalwinsky, DK, Weatherred, WH, Dahl, GV, Bowman, WP, Melvin, SL, Coleman, MS & Bollum, FJ 1981, 'Clinical Utility of Initial Terminal Deoxynucleotidyl Transferase Determinations in Childhood Acute Leukemias', Cancer Research, vol. 41, no. 7, pp. 2877-2881.

Clinical Utility of Initial Terminal Deoxynucleotidyl Transferase Determinations in Childhood Acute Leukemias. / Kalwinsky, David K.; Weatherred, William H.; Dahl, Gary V.; Bowman, W. Paul; Melvin, Susan L.; Coleman, Mary Sue; Bollum, F. J.

In: Cancer Research, Vol. 41, No. 7, 01.07.1981, p. 2877-2881.

Research output: Contribution to journalArticle

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Kalwinsky DK, Weatherred WH, Dahl GV, Bowman WP, Melvin SL, Coleman MS et al. Clinical Utility of Initial Terminal Deoxynucleotidyl Transferase Determinations in Childhood Acute Leukemias. Cancer Research. 1981 Jul 1;41(7):2877-2881.