Clinical and biological heterogeneity of childhood B cell acute lymphocytic leukemia: Implications for clinical trials

M. P. Sullivan, D. J. Pullen, W. M. Crist, M. Brecher, I. Ramirez, H. Sabio, M. J. Borowitz, D. R. Head, L. Cerezo, J. J. Shuster, S. B. Murphy

Research output: Contribution to journalArticlepeer-review

Abstract

Thirty-two children or adolescents had B cell acute lymphocytic leukemia (ALL) diagnosed by demonstration of surface immunoglobulin expression on >10% of their bone marrow blasts. All patients had >25% bone marrow lymphoblasts. Only five of 32 patients (16%) presented with an abdominal mass; however, 24 cases (75%) had FAB L3 morphology. By comparison with findings in common ALL, these 32 children were older (median age, 8 years) and had a higher incidence of central nervous system disease at presentation (22%); all but one were white, and 24 were males. Blast cells from individual cases expressed μκ (n = 13), μλ (n = 9), γκ (n = 1), ακ (n = 1), or μ with an undetermined light chain (n = 8). The most frequently identified cytogenetic abnormality was the classic B cell-associated t(8;14)(q23;q24)(n = 4); the t(1;19)(q23;p13.3), t(9;22)(q23;q11), and t(1;22) were observed in single cases. Twenty patients were treated uniformly on a single protocol designed for children with advanced B cell malignancy; therapy for the other 12 children varied. Nine children (28%) are surviving event-free; all but one for 3 years or more. We conclude that approximately 25% of children with B cell ALL are curable with intensive multiagent chemotherapy and that classification by immunophenotyping is superior to use of clinical and/or lymphoblast morphologic features.

Original languageEnglish (US)
Pages (from-to)6-11
Number of pages6
JournalLeukemia
Volume4
Issue number1
StatePublished - Jan 1990

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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