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Conversion of acute undifferentiated leukemia phenotypes: analysis of clonal development
- Source :
- Leukemia research. 10(11)
- Publication Year :
- 1986
-
Abstract
- The cellular origin of acute undifferentiated leukemia (AUL) is still a matter of controversy. We report on two cases in which the diagnosis of AUL was established according to restricted criteria. Blast cells of both patients showed phenotypic conversion during the course of disease. In one case, within 24 days from starting treatment, the leukemic phenotype changed from AUL to acute myelomonocytic leukemia (FAB Ll, TdT+ to FAB M4, TdT-). The initial phenotype of this acute leukemia was characterized by the co-expression of both B-lymphoid and myeloid markers on the same cell. Moreover, analysis of esterase isoenzyme pattern showed the whole spectrum of isoenzymes typically seen in myelomonocytic leukemias already at diagnosis, yet blast cells additionally contained all three isoenzymes of β-hexosaminidase typically seen in AUL. However, examination of immunoglobulin (Ig) heavy chain gene rearrangement initially and after conversion revealed an identical monoclonal configuration of Ig heavy chain sequences in both samples. The second AUL patient relapsed after allogeneic bone marrow transplantation with common ALL-antigen (CALLA) positive acute leukemia. Subsequent Southern blot analysis showed a novel rearranged Ig fragment compared to the analysis before transplantation indicating that the leukemic clones prior to and after transplantation were not identical. No chromosomal abnormalities were observed in both cases. These data (1) support the view that AUL cells originate from a pluripotent stem cell that is capable to differentiate in the myelomonocytic lineage (patient 1), and (2) confirm the value of Ig gene analysis as marker for cellular clonality.
- Subjects :
- Adult
Cancer Research
Myeloid
Antigens, Neoplasm
Bone Marrow
medicine
Humans
Acute Undifferentiated Leukemia
Child
Acute leukemia
Leukemia
biology
Calla
Antibodies, Monoclonal
Hematology
Gene rearrangement
biology.organism_classification
medicine.disease
Molecular biology
Clone Cells
Transplantation
Leukemia, Myeloid, Acute
medicine.anatomical_structure
Phenotype
Oncology
Immunology
Acute myelomonocytic leukemia
Female
Neprilysin
Subjects
Details
- ISSN :
- 01452126
- Volume :
- 10
- Issue :
- 11
- Database :
- OpenAIRE
- Journal :
- Leukemia research
- Accession number :
- edsair.doi.dedup.....94137367abf640f214a8ac2e7fc9d454