National Cancer Institute®
Last Modified: August 1, 2002
1
UI - 11721435
AU - Fu G; Lu C; Zhang R
TI -
[Deletions and aberrant transcription of p16 and p15 genes in childhood
acute lymphoblastic leukemia]
SO - Zhonghua Xue Ye Xue Za Zhi 1999 Jul;20(7):366-8
AD - Department of Immunology, China Medical University, Shenyang 110001.
OBJECTIVE: To explore the role of p16(MTS1) and p15(MTS2) genes in the
pathogenesis of childhood acute lymphoblastic leukemia(ALL). METHODS:
PCR and Southern blot were used to analyse p16 and p15 gene deletions,
RT-PCR was used to analyse p15 gene transcription. RESULTS: Exon 1 and 2
of p16 gene deletion was detected in 8 of 21 patients(38.1%), and exon 1
and 2 of p15 gene deletion in 11 of 21 patients(52.3%). Aberrant p15
gene transcription was observed in two cases. CONCLUSION: High frequency
of p16 and p15 gene deletions and aberrant transcription may be involved
in the pathogenesis of childhood ALL.
2
UI - 12116073
AU - Liang DC; Shih LY; Yang CP; Hung IJ; Chen SH; Jaing TH; Liu HC; Chang WH
TI -
Multiplex RT-PCR assay for the detection of major fusion transcripts in
Taiwanese children with B-lineage acute lymphoblastic leukemia.
SO - Med Pediatr Oncol 2002 Jul;39(1):12-7
AD - Division of Pediatric Hematology-Oncology, Mackay Memorial Hospital,
Taipei, Taiwan.
BACKGROUND: The classification of B-lineage acute lymphoblastic leukemia
(ALL) by specific chromosomal translocations may have prognostic
implications. Reverse transcriptase-polymerase chain reaction (RT-PCR)
assay is a useful tool for the detection of fusion transcript resulting
from specific chromosomal translocation of the leukemic cells. In
general, fusion transcripts are determined individually, a process which
is labor intensive in order to detect all major fusion transcripts.
PROCEDURE: We use a multiplex RT-PCR assay to detect both the CML- and
ALL-type BCR-ABL transcripts of the t(9;22), all described variants of
the E2A-PBX1 transcripts of t(1;19), the MLL-AF4 transcripts of t(4;11),
and all described variants of TEL-AML1 (also termed ETV6-CBFA2) of the
cryptic t(12;21) in 165 leukemic samples at diagnosis. RESULTS: The
study yielded a completely concordant result with those obtained by the
individual RT-PCR assay. In this cohort of Taiwan children, the relative
frequencies of the four translocations of B-lineage ALL were as
following: 6% with ALL-type t(9;22)/BCR-ABL, 7% t(1;19)/E2A-PBX1, 3%
t(4;11)/MLL-AF4, and 18% t(12;21)/TEL-AML1, comparable to those in the
Western countries. CONCLUSION: Multiplex RT-PCR assay is an efficient,
sensitive, accurate, and cost-effective diagnostic tool, which will
likely improve our ability in accurately and rapidly risk-stratifying
children with ALL. Copyright 2002 Wiley-Liss, Inc.
3
UI - 12116079
AU - Barr RD; Guo CY; Wiernikowski J; Webber C; Wright M; Atkinson S
TI -
Osteopenia in children with acute lymphoblastic leukemia: a pilot study
of amelioration with Pamidronate.
SO - Med Pediatr Oncol 2002 Jul;39(1):44-6
AD - Faculty of Health Sciences, McMaster University, Hamilton, Ontario,
Canada.
4
UI - 12008081
AU - Ravandi F; Cortes J; Estrov Z; Thomas D; Giles FJ; Huh YO; Pierce S;
TI -
O'Brien S; Faderl S; Kantarjian HM
CD56 expression predicts occurrence of CNS disease in acute
lymphoblastic leukemia.
SO - Leuk Res 2002 Jul;26(7):643-9
AD - Department of Hematology/Oncology, University of Illinois, Chicago, IL,
USA.
We examined the pre-treatment bone marrow samples from 200 consecutive
adult patients with acute lymphoblastic leukemia (ALL) treated on
various protocols at the University of Texas, M.D. Anderson Cancer
Center between 1986 and 1998. Standard MFC techniques were used to
determine CD56 expression on the leukemia blasts cells. The expression
of CD56 was correlated with clinical characteristics at diagnosis,
response to therapy, survival and disease-free survival.Blast expression
of CD56 (> or = 20% of leukemic blasts) was seen in 16 (8%) of patients,
with a median expression of 67% (range 20-99%). CD56 expression was
associated with a higher incidence of central nervous system (CNS)
disease at diagnosis (19% versus 4%; P=0.016). Incidence of CNS disease
at any time was higher in patients with CD56+ disease (31% versus 14%;
P=0.057). Among the 109 patients uniformly treated with the hyperCVAD
regimen, CD56 expression was associated with a statistically significant
higher incidence of CNS disease (33% versus 9%; P=0.026). CD56
expression in ALL is uncommon but may predict a higher risk for CNS
disease. If these results are confirmed, CD56 expression could be used
in combination with other high-risk features (e.g. lactate dehydrogenase
(LDH), S-phase fraction, mature B-cell phenotype) to design a
risk-oriented approach to CNS prophylaxis.
5
UI - 12008082
AU - Dorak MT; Oguz FS; Yalman N; Diler AS; Kalayoglu S; Anak S; Sargin D;
TI -
Carin M
A male-specific increase in the HLA-DRB4 (DR53) frequency in high-risk
and relapsed childhood ALL.
SO - Leuk Res 2002 Jul;26(7):651-6
AD - Department of Epidemiology and International Health, School of Public
Health, University of Alabama at Birmingham, AL 35294-0022, USA.
dorak@openlink.org
Previous studies reported significant HLA-DR associations with various
leukemias one of which is with HLA-DRB4 (DR53) family in male patients
with childhood ALL. We have HLA-DR-typed 212 high-risk or relapsed
patients with childhood (n=114) and adult (n=98) ALL and a total of 250
healthy controls (118 children, 132 adult) by PCR-SSP analysis. The
members of the HLA-DRB3 (DR52) family were underrepresented in patients
most significantly for HLA-DRB1*12 (P=0.0007) and HLA-DRB1*13
(P=0.0001). In childhood ALL, the protective effect of DRB3 was evident
in homozygous form (P=0.001). The DRB4 marker frequency was increased in
males with childhood ALL (67.4%) compared to age- and sex-matched
controls (42.1%, P=0.003) and female patients (35.7%, P=0.004). Besides
being a general marker for increased susceptibility to childhood ALL in
males, HLA-DRB4 is over-represented in high-risk patients. These results
further suggest that the HLA system is one of the components of genetic
susceptibility to leukemia but mainly in childhood and in boys only.
6
UI - 11872238
AU - Brouwer RE; van der Heiden P; Schreuder GM; Mulder A; Datema G; Anholts
TI -
JD; Willemze R; Claas FH; Falkenburg JH
Loss or downregulation of HLA class I expression at the allelic level in
acute leukemia is infrequent but functionally relevant, and can be
restored by interferon.
SO - Hum Immunol 2002 Mar;63(3):200-10
AD - Laboratory of Experimental Hematology, Department of Hematology, Leiden,
The Netherlands.
Human leukocyte antigen (HLA) class I expression at the allelic level
was analyzed in 397 acute myeloid leukemia (AML) and 186 acute lymphoid
leukemia (ALL) using a complement-dependent cytotoxicity assay. Impaired
recognition possibly due to HLA downregulation was observed in 2% of the
patients with AML and ALL in complete remission, and in 8%-15% in the
groups with blasts. In 15 instances of diminished cytotoxicity, leukemic
cells and control PHA blasts from the same patients were further
analyzed using flow cytometry. In 4/6 ALL and 4/9 AML patients HLA
downregulation or complete loss (2 patients) of cell surface expression
could be confirmed. No genomic abnormalities were observed. In addition,
12 AML and 13 ALL patients were tested during relapse using flow
cytometry. In 1/12 AML patients and 1/13 ALL patients allelic
downregulation of cell surface expression was found. In two patients
tested, downregulation or loss of cell surface expression of HLA class I
antigens corresponded with impaired T cell mediated lysis by HLA
restricted cytotoxic T lymphocyte.Treatment of the cells with alpha- or
gamma-interferon could restore HLA class I expression and T-cell
recognition. In conclusion, downregulation of cell surface expression of
HLA class I expression at the allelic level in AML and ALL is infrequent
but functionally relevant. HLA downregulation was reversible and T-cell
recognition could be restored by alpha- or gamma-interferon.
7
UI - 12070010
AU - Davies SM; Bhatia S; Ross JA; Kiffmeyer WR; Gaynon PS; Radloff GA;
TI -
Robison LL; Perentesis JP
Glutathione S-transferase genotypes, genetic susceptibility, and outcome
of therapy in childhood acute lymphoblastic leukemia.
SO - Blood 2002 Jul 1;100(1):67-71
AD - Children's Oncology Group, Arcadia, CA 91066-6012, USA. davie008@umn.edu
The glutathione S-transferase (GST) genes are involved in the metabolism
of environmental carcinogens and of some classes of chemotherapy drugs.
GSTM1 and GSTT1 genotypes are polymorphic in humans, and the phenotypic
absence of enzyme activity is caused by a homozygous inherited deletion
of the gene. Previous, smaller studies of childhood acute lymphoblastic
leukemia (ALL) provided contrasting data on the role of the GST genotype
in susceptibility and treatment outcomes. We analyzed GST genotypes in
710 children with ALL treated by the Children's Cancer Group.
Frequencies were compared with those of normal controls, and outcomes
were analyzed according to genotype. Comparisons of gene frequencies in
ALL case and control patients showed similar frequencies (54% vs 53%
GSTM1 null in whites, P =.9; 40% versus 32% in blacks, P =.45; 16%
versus 15% GSTT1 null in whites, P =.8; 17% versus 28% in blacks, P
=.3). ALL was not associated with the GSTM1-null genotype or the
double-null genotype in blacks or whites, in contrast to previous
reports. Stratification of cases by age at diagnosis, sex, white blood
cell count at diagnosis, B or T lineage, or cytogenetics revealed no
differences in genotype frequencies. Analysis of treatment outcomes
showed no differences in outcome according to GST genotype; in
particular, there were no differences in frequencies of relapse at any
site. These data, representing a larger series than any reported
previously, suggest that GST genotype does not affect etiology or
outcome of childhood ALL.
8
UI - 12086890
AU - Ferrando AA; Neuberg DS; Staunton J; Loh ML; Huard C; Raimondi SC; Behm
TI -
FG; Pui CH; Downing JR; Gilliland DG; Lander ES; Golub TR; Look AT
Gene expression signatures define novel oncogenic pathways in T cell
acute lymphoblastic leukemia.
SO - Cancer Cell 2002 Feb;1(1):75-87
AD - Department of Pediatric Oncology, Dana-Farber Cancer Institute and
Harvard Medical School, Boston, MA 02142, USA.
Human T cell leukemias can arise from oncogenes activated by specific
chromosomal translocations involving the T cell receptor genes. Here we
show that five different T cell oncogenes (HOX11, TAL1, LYL1, LMO1, and
LMO2) are often aberrantly expressed in the absence of chromosomal
abnormalities. Using oligonucleotide microarrays, we identified several
gene expression signatures that were indicative of leukemic arrest at
specific stages of normal thymocyte development: LYL1+ signature
(pro-T), HOX11+ (early cortical thymocyte), and TAL1+ (late cortical
thymocyte). Hierarchical clustering analysis of gene expression
signatures grouped samples according to their shared oncogenic pathways
and identified HOX11L2 activation as a novel event in T cell
leukemogenesis. These findings have clinical importance, since HOX11
activation is significantly associated with a favorable prognosis, while
expression of TAL1, LYL1, or, surprisingly, HOX11L2 confers a much worse
response to treatment. Our results illustrate the power of gene
expression profiles to elucidate transformation pathways relevant to
human leukemia.
9
UI - 12086866
AU - Staudt LM
TI -
It's ALL in the diagnosis.
SO - Cancer Cell 2002 Mar;1(2):109-10
AD - Metabolism Branch, Center for Cancer Research, National Cancer
Institute, 9000 Rockville Pike, Bethesda, MD 20892, USA.
Istaudt@mail.nih.gov
The molecular diagnosis of human cancer will hasten the development of
treatments tailored to the abnormalities present in each patient's tumor
cells. Recent gene expression profiling studies of pediatric acute
lymphoblastic leukemia (ALL) suggest that the molecular diagnosis of
these diseases is right around the corner.
10
UI - 12086872
AU - Yeoh EJ; Ross ME; Shurtleff SA; Williams WK; Patel D; Mahfouz R; Behm
TI -
FG; Raimondi SC; Relling MV; Patel A; Cheng C; Campana D; Wilkins D;
Zhou X; Li J; Liu H; Pui CH; Evans WE; Naeve C; Wong L; Downing JR
Classification, subtype discovery, and prediction of outcome in
pediatric acute lymphoblastic leukemia by gene expression profiling.
SO - Cancer Cell 2002 Mar;1(2):133-43
AD - Department of Pathology, St. Jude Children's Research Hospital, Memphis,
TN 38105, USA.
Treatment of pediatric acute lymphoblastic leukemia (ALL) is based on
the concept of tailoring the intensity of therapy to a patient's risk of
relapse. To determine whether gene expression profiling could enhance
risk assignment, we used oligonucleotide microarrays to analyze the
pattern of genes expressed in leukemic blasts from 360 pediatric ALL
patients. Distinct expression profiles identified each of the
prognostically important leukemia subtypes, including T-ALL, E2A-PBX1,
BCR-ABL, TEL-AML1, MLL rearrangement, and hyperdiploid >50 chromosomes.
In addition, another ALL subgroup was identified based on its unique
expression profile. Examination of the genes comprising the expression
signatures provided important insights into the biology of these
leukemia subgroups. Further, within some genetic subgroups, expression
profiles identified those patients that would eventually fail therapy.
Thus, the single platform of expression profiling should enhance the
accurate risk stratification of pediatric ALL patients.
11
UI - 11866371
AU - Levien MG
TI -
Osteonecrosis as a complication of treating acute lymphoblastic leukemia
in children: a report from the Children's Cancer Group.
SO - Clin Pediatr (Phila) 2002 Jan-Feb;41(1):63-4
AD - Cleveland Clinic Foundation, USA.
12
UI - 12146036
AU - Kashima K; Nagahama J; Sato K; Tanamachi H; Gamachi A; Daa T; Nakayama
TI -
I; Yokoyama S
Detection of the HTLV-I gene on cytologic smear slides.
SO - Acta Cytol 2002 Jul-Aug;46(4):709-12
AD - Department of Pathology, Oita Medical University Hospital, First
Department of Pathology, Oita Medical University, Oita, Japan.
kkashima@oita-med.ac.jp
OBJECTIVE: To apply the polymerase chain reaction (PCR) for detection of
the HTLV-I gene from cytologic smear slides. STUDY DESIGN: Samples were
from seven cases of serum anti-ATL antibody (ATLA)-positive T-cell
lymphoma and three from ATLA-negative T-cell lymphoma. Six of the seven
ATLA-positive cases were confirmed to be ATLL by Southern blotting. From
the seventh case a fresh sample for blotting could not obtained. DNA was
extracted from the cytologic smear slides of all 10 cases; they had been
stained with Papanicolaou or May-Giemsa stain, digested with proteinase
K and precipitated with phenol and ethanol. The target sequence in the
pX region of the HTLV-I gene was amplified by PCR. RESULTS: All seven
ATLA-positive cases, including one that had not yet been confirmed by
Southern blotting, showed a single band, as predicted, while the three
ATLA-negative cases showed no band. CONCLUSION: If cytologic smear
slides are available but a fresh sample is not, the PCR method should
provide evidence that the virus is present since in our study sufficient
DNA templates were successfully extracted from the stained cytologic
smear slides for detection of the virus.
13
UI - 12142782
AU - Kham SK; Tan PL; Tay AH; Heng CK; Yeoh AE; Quah TC
TI -
Thiopurine methyltransferase polymorphisms in a multiracial asian
population and children with acute lymphoblastic leukemia.
SO - J Pediatr Hematol Oncol 2002 Jun-Jul;24(5):353-9
AD - Department of Pediatrics, National University of Singapore, Singapore.
The purpose of this study was to determine the frequency of thiopurine
methyltransferase (TPMT) polymorphisms in a multiracial Asian population
and to assess its relevance in the management of childhood acute
lymphoblastic leukemia (ALL). Six hundred unrelated cord blood samples
from 200 Chinese, Malay, and Indian healthy newborns were collected at
the National University Hospital, Singapore; an additional 100 children
with ALL were analyzed for five of the commonly reported TPMT variant
alleles using polymerase chain reaction/restriction fragment length
polymorphism and allele-specific polymerase chain reaction-based assays.
In the cord blood study, the TPMT*3C variant was detected in all three
ethnic groups; Chinese, Malays, and Indians had allele frequencies of
3%, 2.3%, and 0.8%, respectively. The TPMT*3A variant was found only
among the Indians at a low allele frequency of 0.5%. The TPMT*6 variant
was found in one Malay sample. Among the children with ALL, two white
and one Chinese were heterozygous for the TPMT*3A variant and showed
intermediate sensitivity to 6-mercaptopurine during maintenance therapy.
Three Chinese patients and one Malay patient were heterozygous for the
TPMT*3C variant. Mercaptopurine sensitivity could be validated in only
one out of four TPMT*3C heterozygous patients. The overall allele
frequency of the TPMT variants in this multiracial population was 2.5%.
The TPMT*3C was the most common variant allele; TPMT*3A and TPMT*6 were
rare. These results support the feasibility of performing TPMT
genotyping in all children diagnosed with acute leukemia to minimize
toxicity from thiopurine chemotherapy.
14
UI - 12145681
AU - van der Velden VH; Jacobs DC; Wijkhuijs AJ; Comans-Bitter WM; Willemse
TI -
MJ; Hahlen K; Kamps WA; van Wering ER; van Dongen JJ
Minimal residual disease levels in bone marrow and peripheral blood are
comparable in children with T cell acute lymphoblastic leukemia (ALL),
but not in precursor-B-ALL.
SO - Leukemia 2002 Aug;16(8):1432-6
AD - Department of Immunology, Erasmus MC, Erasmus University Medical Center,
Rotterdam, The Netherlands.
Sensitive and quantitative detection of minimal residual disease (MRD)
in bone marrow (BM) samples of children with acute lymphoblastic
leukemia (ALL) is essential for evaluation of early treatment response.
In this study, we evaluated whether the traumatic BM samplings can be
replaced by peripheral blood (PB) samplings. MRD levels were analyzed in
follow-up samples of 62 children with precursor-B-ALL (532 paired BM-PB
samples) and 22 children with T-ALL (149 paired BM-PB samples) using
real-time quantitative PCR (RQ-PCR) analysis of immunoglobulin and T
cell receptor gene rearrangements with sensitivities of 10(-3) to 10(-5)
(one ALL cell in 10(3) to 10(5) normal cells). In 14 of the 22 T-ALL
patients, detectable MRD levels were found in 67 paired BM-PB samples:
in 47 pairs MRD was detected both in BM and PB, whereas in the remaining
pairs very low MRD levels were detected in BM (n = 11) or PB (n = 9)
only. The MRD levels in the paired BM-PB samples were very comparable
and strongly correlated (r(s) = 0.849). Comparable results were obtained
earlier by immunophenotyping in 26 T-ALL patients (321 paired BM-PB
samples), which also showed a strong correlation between MRD levels in
paired BM and PB samples (r(s) = 0.822). In 39 of the 62 precursor-B-ALL
patients, MRD was detected in 107 BM-PB pairs: in 48 pairs MRD was
detected in both BM and PB, in 47 pairs MRD was solely detected in BM
(at variable levels), and in 12 pairs only the PB sample was
MRD-positive at very low levels (=10(-4)). Furthermore, in the 48
double-positive pairs, MRD levels in BM and PB varied enormously with
MRD levels in BM being up to 1000 times higher than in the corresponding
PB samples. Consequently, BM samples cannot easily be replaced by PB
sampling for MRD analysis in childhood precursor-B-ALL, in line with
their BM origin. In T-ALL, which are of thymic origin, BM sampling might
be replaced by PB sampling, because the dissemination of T-ALL cells to
BM and PB appears to be comparable.
15
UI - 12145701
AU - Alves S; Amorim A; Ferreira F; Norton L; Prata MJ
TI -
The GSTM1 and GSTT1 genetic polymorphisms and susceptibility to acute
lymphoblastic leukemia in children from north Portugal.
SO - Leukemia 2002 Aug;16(8):1565-7
16
UI - 11154239
AU - Carter TL; Watt PM; Kumar R; Burton PR; Reaman GH; Sather HN; Baker DL;
TI -
Kees UR
Hemizygous p16(INK4A) deletion in pediatric acute lymphoblastic leukemia
predicts independent risk of relapse.
SO - Blood 2001 Jan 15;97(2):572-4
AD - Division of Children's Leukaemia and Cancer Research, TVWT Institute for
Child Health Research, University of Western Australia, West Perth.
The genes at the INK4A/ARF locus at 9p21 are frequently involved in
human cancer. Virtually all p16(INK4A) exon 2 (henceforth called p16)
inactivation in pediatric acute lymphoblastic leukemia (ALL) occurs by
gene deletion. The results of this study illustrate that real-time
quantitative polymerase chain reaction is capable of detecting gene
deletion in primary patient specimens with a precision not previously
achieved by conventional methods. Importantly, this assay includes the
detection of hemizygous deletions. The study revealed, strikingly, that
the risk ratio for relapse for hemizygous deletion compared with no
deletion was 6.558 (P =.00687) and for homozygous deletion was 11.558 (P
=.000539). These results confirm and extend the authors' previous
findings that homozygous deletion of p16 in pediatric ALL patients is an
independent prognostic indicator of outcome from therapy.
17
UI - 11405214
AU - Graf Einsiedel H; Taube T; Hartmann R; Eckert C; Seifert G; Wellmann S;
TI -
Henze G; Seeger K
Prognostic value of p16(INK4a) gene deletions in pediatric acute
lymphoblastic leukemia.
SO - Blood 2001 Jun 15;97(12):4002-4
18
UI - 11778693
AU - Moynet D; Pouliquen JF; Londos-Gagliardi D; Buigues RP; Moreau JF;
TI -
Bedjabaga I; Georges MC; Talarmin A; Joubert M; Fleury H; Vincendeau P;
Guillemain B
High variability of HTLV-I in a remote population of Gabon as compared
to that of a similar population of French Guiana.
SO - Virus Genes 2001 Dec;23(3):257-61
AD - Immunologie Moleculaire et Parasitologie, Universite Bordeaux2, France.
daniel.moynet@immol.u-bordeaux2.fr
An anomalous high frequency of ATL was observed in a remote 'noir
maroons' village of French Guiana. Since it is not clear if HTLV-I is
responsible for different frequencies of disease in different
geographical areas, we undertook a comparison of the population with a
similar one located in Gabon. We found a much higher degree of gp46
surface envelope glycoprotein sequence conservation in the Guianese
village than in the Gabonese one.
19
UI - 11899114
AU - Ou SX; Han D; Severson RK; Chen Z; Neglia JP; Reaman GH; Buckley JD;
TI -
Robison LL
Birth characteristics, maternal reproductive history, hormone use during
pregnancy, and risk of childhood acute lymphocytic leukemia by
immunophenotype (United States).
SO - Cancer Causes Control 2002 Feb;13(1):15-25
AD - Department of Pediatrics, University of Minnesota, Minneapolis, USA.
Xiao-Ou.Shu@mcmail.vanderbilt.edu
OBJECTIVE: To investigate the associations of birth characteristics and
maternal reproductive factors with risk of childhood acute lymphoblastic
leukemia (ALL) by immunophenotypic subtypes. METHODS: Data collected
from a case-control study including 1842 ALL cases (age < 15 years) and
1986 individually matched controls were analyzed. Exposure information
was obtained through telephone interviews of parents. RESULTS: Factors
associated with risk of ALL from all subgroups combined included high
birth weight (OR = 1.4, 95% CI = 1.1-1.8), high birth order (OR = 2.0,
95% CI = 1.3-3.0 for fourth-born child compared to first-born child).
young maternal age (<20 compared to 25-29, OR = 1.4, 95% CI = 1.1-1.9),
advanced paternal age (>39 compared to 25-29, OR = 1.4, 95% CI =
1.0-1.9), induced abortion prior to the index pregnancy (OR = 1.2, 95%
CI = 1.0-1.4), and oral contraceptive use during the index pregnancy (OR
= 1.5, 95% CI = 1.0-2.2) with children under the age of 2 (OR = 5.1, 95%
CI = 1.0-24.7) being the predominantly affected group. Risk of early
pre-B-cell ALL increased with advanced paternal age (OR = 1.7, 95% CI =
1.1-2.7) and high birth order (OR = 2.0, 95% CI = 1.1-3.6), while risk
of pre-B-cell ALL increased with both younger (OR = 3.4, 95% CI =
1.4-8.4) and advanced maternal age (OR = 2.6, 95% CI = 1.1-5.9). T-cell
ALL was associated with high birth weight (OR = 2.4, 95% CI = 1.1-5.5)
and history of induced abortion (OR = 2.4, 95% CI = 1.3-4.5).
CONCLUSION: This study suggests that the association of ALL with birth
characteristics and maternal reproductive factors varies with the
immunophenotype of the ALL. Future studies are needed to better
understand the effect of maternal hormone in the development of subtype
of childhood ALL.
20
UI - 11899117
AU - Ekstrom K; Wuu J; Hsieh CC; Glimelius B; Lambe M
TI -
Childbearing and the risk of leukemia in Sweden.
SO - Cancer Causes Control 2002 Feb;13(1):47-53
AD - Department of Medical Epidemiology, Karolinska Institutet, Stockholm,
Sweden. karin.ekstrom@mep.ki.se
OBJECTIVE: The possible influence of childbearing on the development of
leukemias in females has received little attention, in spite of
consistent findings of lower incidence rates in females than in males. A
nested case-control study was undertaken to explore if parity and age at
first birth affect the risk of developing these malignancies. METHODS:
In a nationwide cohort defined by a population-based Fertility Register,
we identified 356 women with chronic myeloid leukemia (CML), 819 with
acute nonlymphocytic leukemia (ANLL), and 179 with acute lymphocytic
leukemia (ALL). For each case, five age-matched controls were selected.
Odds ratios were estimated by conditional logistic regression analyses.
RESULTS: There was some evidence of weak negative associations between
parity and age at first birth for CML. Compared to nulliparous women
there was a tendency of a temporal risk reduction of CML for the first
10 years following a delivery. The risk of ANLL was slightly lower in
parous compared to nulliparous women. Neither parity nor age at first
birth was related to the risk of ALL. CONCLUSIONS: We conclude that if
pregnancy-related hormonal or immunological factors have an effect on
the development of leukemia, it is minor and confined to the myeloid
types, chiefly CML. Our study gives some support for treating the
leukemias as separate entities based on both cell lineage and form in
future etiologic studies.
21
UI - 12091359
AU - Hotfilder M; Rottgers S; Rosemann A; Jurgens H; Harbott J; Vormoor J
TI -
Immature CD34+CD19- progenitor/stem cells in TEL/AML1-positive acute
lymphoblastic leukemia are genetically and functionally normal.
SO - Blood 2002 Jul 15;100(2):640-6
AD - Department of Pediatric Hematology and Oncology, University Children's
Hospital Muenster, Germany.
One important question in stem cell biology of childhood acute
lymphoblastic leukemia (ALL) is whether immature CD34+CD19- cells are
part of the leukemic cell clone. CD34+CD19- cells from the bone marrow
of 9 children with TEL/AML1-positive ALL were purified by flow sorting
and subjected to reverse transcriptase-polymerase chain reaction
(RT-PCR), fluorescence in situ hybridization, and methylcellulose
cultures. In 3 of 8 patients analyzed by RT-PCR, no TEL/AML1-positive
cells could be detected in the CD34+CD19- cell fraction. Altogether, the
percentage of TEL/AML1-positive cells was low: 1.6% (n = 8; SD 2.2%) by
nested real-time RT-PCR and 2.5% (n = 5; SD 2.6%) by fluorescence in
situ hybridization. This correlated with the percentage of contaminating
CD19+ leukemic cells in the CD34+CD19- cell fraction in 6 control sorts
(mean 4.6%, SD 3.6%), indicating that the low levels of leukemic cells
detected in the CD34+CD19- cell fraction could be attributed to sorter
errors. Methylcellulose cultures in 3 patients provided further evidence
that CD34+CD19- cells represent a candidate normal cell population. The
clonogenicity of the CD34+CD19- cell fraction was similar to normal
progenitors, including growth of primitive granulocyte, erythroid,
macrophage, megakaryocyte colony-forming units. Each of 92 colonies from
cultures with CD34+CD19- cells tested negative for TEL/AML1. In
conclusion, our data support the hypothesis that the leukemia in
TEL/AML1-positive childhood ALL originates in a CD19+ lymphoid
progenitor. This has many therapeutic implications, eg, for purging of
autologous stem cell products, flow cytometric monitoring of minimal
residual disease, and targeting immunotherapy against the leukemic cell
clone.
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