Document Detail


Clinical and biological aspects of acute lymphoblastic leukemia in 62 infants: retrospective analysis of the Tokyo Children's Cancer Study Group.
MedLine Citation:
PMID:  10530057     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: As a first step to formulate a new treatment strategy for refractory acute lymphoblastic leukemia (ALL) in infants, clinical results and immunophenotypic and cytogenetic data were analyzed and compared with those from overseas. METHODS: There were 62 infants with ALL who were treated between 1977 and 1995 at 30 institutions affiliated with the Tokyo Children's Cancer Study Group. Clinical and laboratory data obtained from these infants (all under 1 year of age) were retrospectively studied. RESULTS: The morphological diagnoses were FAB-L1 for 51 patients (82.2%) and FAB-L2 for 11 patients (17.8%). Hepatomegaly and splenomegaly were found in 40 (70.0%) and 40 patients (68.3%), respectively. The mean (+/- SEM) leukocyte count at diagnosis was 205,900 +/- 35,700/microL. The involvement of the central nervous system was evident in nine of 36 patients who were subjected to lumbar puncture, while three of these nine patients were free of neurological symptoms at diagnosis. Thirty-one patients (55.4%) were CD10 negative and 14 (25.0%) were CD10 positive. Thirty-one of 47 patients (65.9%) exhibited chromosomal abnormalities, including 28 patients (59.6%) with 11q23 abnormalities. Rearrangements in the MLL gene were found in nine of 13 infants (69.2%) examined. Translocation of 11q23 and/or MLL gene rearrangement (11q23/MLL) was significantly associated with the absence of the CD10 antigen. Hyperleukocytosis of more than 50,000/microL and 11q23/MLL gene rearrangements were related to a poor prognosis. The probability of an event-free survival in 62 infants was 13.1 +/- 4.8% at 48 months. CONCLUSIONS: New therapeutic strategies and large-scale cooperative prospective trials are needed to improve the prognosis of ALL in infants.
Authors:
K Isoyama; H Okawa; Y Hayashi; R Hanada; Y Okimoto; M Maeda; T Saito; M Tsuchida; S Nakazawa
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatrics international : official journal of the Japan Pediatric Society     Volume:  41     ISSN:  1328-8067     ISO Abbreviation:  Pediatr Int     Publication Date:  1999 Oct 
Date Detail:
Created Date:  1999-11-04     Completed Date:  1999-11-04     Revised Date:  2008-05-21    
Medline Journal Info:
Nlm Unique ID:  100886002     Medline TA:  Pediatr Int     Country:  AUSTRALIA    
Other Details:
Languages:  eng     Pagination:  477-83     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, Showa University Fujigaoka Hospital, Kanagawa, Japan. isoyamak@med.showa-u.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Chromosomes, Human, Pair 11 / genetics
Female
Humans
Immunophenotyping
Infant
Infant, Newborn
Male
Precursor Cell Lymphoblastic Leukemia-Lymphoma / genetics,  immunology,  mortality,  physiopathology*,  therapy
Retrospective Studies
Survival Rate
Tokyo / epidemiology
Translocation, Genetic
Treatment Outcome

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