Transitional pre-B-cell acute lymphoblastic leukemia of childhood is associated with favorable prognostic clinical features and an excellent outcome: A pediatric oncology group study

M. Koehler, F. G. Behm, J. Shuster, W. Crist, M. Borowitz, A. T. Look, D. Head, A. J. Carroll, V. Land, P. Steuber, D. J. Pullen

Research output: Contribution to journalArticlepeer-review

Abstract

The presenting characteristics and survival of children with the newly recognized transitional cell pre-B imrnunophenotype of acute lymphoblastic leukemia (ALL) are compared with those of children with pre-B ALL to determine the clinical significance of the new phenotype. Patients with transitional pre-B ALL (n = 17), defined by lymphoblasts expressing cytoplasmic and surface μ heavy chains without κ or λ light chains, have lower initial leukocyte counts (p = 0.02) and a higher frequency of DNA indexes > 1.16 (p < 0.001) than patients with pre-B ALL (n = 501), whether or not cases with the unfavorable prognostic (1;19) translocation are included in the analysis. Patients with transitional pre-B ALL lack FAB L3 morphology, bulky extramedullary disease, surface κ or λ chains, and the (8;14), (8;22), and (2;8) translocations, features that characterize the syndrome of B-cell ALL. The 4-year relapse-free survival result for children with transitional pre-B ALL appears better than that for children with pre-B ALL (93.3 ± 17% versus 72.9% ± 4.6%), but this difference is not statistically significant. We conclude that patients with transitional pre-B ALL have a very favorable prognosis in the context of the therapy used in this study.

Original languageEnglish (US)
Pages (from-to)2064-2068
Number of pages5
JournalLeukemia
Volume7
Issue number12
StatePublished - Dec 1993
Externally publishedYes

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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