TY - JOUR
T1 - Relationship of pretreatment lymphoblast proliferative activity and prognosis in 97 children with acute lymphoblastic leukemia
AU - Dow, L. W.
AU - Chang, L. J.A.
AU - Tsiatis, A. A.
AU - Melvin, S. L.
AU - Bowman, W. P.
PY - 1982
Y1 - 1982
N2 - We have analyzed the pretreatment 3H-thymidine labeling indices in blood and marrow blast cells from 97 children with acute lymphoblastic leukemia (ALL) and circulating blasts. The median marrow labeling index (LI) was 6.2% (range 0.8%-32.7%) and the median blood LI, 3.2% (range 0.3%-20%). Blood LI was significantly correlated with leukocyte count and rosette-forming (E +) lymphoblasts but not with central nervous system leukemia or thymic mass at diagnosis. Marrow LI was related to E + blasts only. In children with E + leukemia, both blood and marrow LIs were significantly higher than values for other ALL subtypes (p < 0.01) excluding undifferentiated ALL, which was characterized by an increased blood LI. Eighteen patients had a blood LI that either equaled or exceeded the marrow LI; apart from age, the clinical features, blast phenotypes and treatment responses of this group were similar to those of patients with blood LI less than marrow LI. Among 51 patients assessed for treatment response, the estimated median length of remission was significantly shorter for those with a blood LI >4% (p = 0.002) or a marrow LI >6% (p = 0.01). By Cox-regression analysis, the pretreatment proliferative activity of blood and marrow blasts, unlike other initial features studied, added significant prognostic information to leukocyte count in these patients with circulating blasts. The findings provide a cogent explanation for the differential clinical responsiveness of commonly recognized ALL subclasses.
AB - We have analyzed the pretreatment 3H-thymidine labeling indices in blood and marrow blast cells from 97 children with acute lymphoblastic leukemia (ALL) and circulating blasts. The median marrow labeling index (LI) was 6.2% (range 0.8%-32.7%) and the median blood LI, 3.2% (range 0.3%-20%). Blood LI was significantly correlated with leukocyte count and rosette-forming (E +) lymphoblasts but not with central nervous system leukemia or thymic mass at diagnosis. Marrow LI was related to E + blasts only. In children with E + leukemia, both blood and marrow LIs were significantly higher than values for other ALL subtypes (p < 0.01) excluding undifferentiated ALL, which was characterized by an increased blood LI. Eighteen patients had a blood LI that either equaled or exceeded the marrow LI; apart from age, the clinical features, blast phenotypes and treatment responses of this group were similar to those of patients with blood LI less than marrow LI. Among 51 patients assessed for treatment response, the estimated median length of remission was significantly shorter for those with a blood LI >4% (p = 0.002) or a marrow LI >6% (p = 0.01). By Cox-regression analysis, the pretreatment proliferative activity of blood and marrow blasts, unlike other initial features studied, added significant prognostic information to leukocyte count in these patients with circulating blasts. The findings provide a cogent explanation for the differential clinical responsiveness of commonly recognized ALL subclasses.
UR - http://www.scopus.com/inward/record.url?scp=0019957257&partnerID=8YFLogxK
U2 - 10.1182/blood.v59.6.1197.bloodjournal5961197
DO - 10.1182/blood.v59.6.1197.bloodjournal5961197
M3 - Article
C2 - 6952944
AN - SCOPUS:0019957257
VL - 59
SP - 1197
EP - 1202
JO - Unknown Journal
JF - Unknown Journal
IS - 6
ER -