Initial prognostic factors and lymphoblast-erythrocyte rosette formation in 109 children with acute lymphoblastic leukemia

Abstract Bone marrow lymphoblasts from 109 children admitted with untreated acute lymphoblastic leukemia (ALL) were tested for spontaneous rosette formation with sheep erythrocytes. Twenty-six children (24%) had lymphoblasts that formed rosettes (E+). Of 13 initial clinical characteristics, 8 were significantly associated with E+ lymphoblasts: mediastinal enlargement (86% of patients E+), leukocyte counts over 100 X 10(9)/liter (65% E+), nodes greater than 2 cm in any diameter (65% E+), age over 5 yr (46% E+), hemoglobin over 8 g/dl (44% E+), hepatomegaly greater than 5 cm (38% E+), boys (35% E+), and lymph node enlargement outside of the cervical area (28% E+). Spleen size, initial platelet counts, and periodic acid-Schiff scores did not distinguish E+ from E- patients. Since few patients were black and few presented with central nervous system leukemia, the association of these two characteristics with E+ blasts could not be determined. A hierarchical classification scheme and a linear logistic regression model were used to define the patterns of characteristics associated with E+ lymphoblasts. The initial clinical characteristics and the poorer course of E+ patients suggest that ALL comprises at least two biologically and clinically distinct types. The E+ ALL may result from a leukemic transformation of a non-Hodgkin lymphoma.

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Initial prognostic factors and lymphoblast-erythrocyte rosette formation in 109 children with acute lymphoblastic leukemia

Blood ◽

10.1182/blood.v50.4.671.bloodjournal504671 ◽

1977 ◽

Vol 50 (4) ◽

pp. 671-682

Author(s):

LW Dow ◽

L Borella ◽

L Sen ◽

RJ Aur ◽

SL George ◽

...

Keyword(s):

Acute Lymphoblastic Leukemia ◽

Clinical Characteristics ◽

Lymphoblastic Leukemia ◽

Periodic Acid ◽

Hierarchical Classification ◽

Rosette Formation ◽

Periodic Acid Schiff ◽

Non Hodgkin Lymphoma ◽

Lymph Node Enlargement ◽

Leukocyte Counts

Bone marrow lymphoblasts from 109 children admitted with untreated acute lymphoblastic leukemia (ALL) were tested for spontaneous rosette formation with sheep erythrocytes. Twenty-six children (24%) had lymphoblasts that formed rosettes (E+). Of 13 initial clinical characteristics, 8 were significantly associated with E+ lymphoblasts: mediastinal enlargement (86% of patients E+), leukocyte counts over 100 X 10(9)/liter (65% E+), nodes greater than 2 cm in any diameter (65% E+), age over 5 yr (46% E+), hemoglobin over 8 g/dl (44% E+), hepatomegaly greater than 5 cm (38% E+), boys (35% E+), and lymph node enlargement outside of the cervical area (28% E+). Spleen size, initial platelet counts, and periodic acid-Schiff scores did not distinguish E+ from E- patients. Since few patients were black and few presented with central nervous system leukemia, the association of these two characteristics with E+ blasts could not be determined. A hierarchical classification scheme and a linear logistic regression model were used to define the patterns of characteristics associated with E+ lymphoblasts. The initial clinical characteristics and the poorer course of E+ patients suggest that ALL comprises at least two biologically and clinically distinct types. The E+ ALL may result from a leukemic transformation of a non-Hodgkin lymphoma.

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Periodic Acid-Schiff Stain in Childhood Acute Lymphoblastic Leukemia: Lack of Independent Prognostic Value

American Journal of Clinical Pathology ◽

10.1093/ajcp/83.4.494 ◽

1985 ◽

Vol 83 (4) ◽

pp. 494-497

Author(s):

Gary R. Lanham ◽

David K. Kalwinsky ◽

Dorothy L. Williams ◽

Susan L. Melvin ◽

Jerry R. Harber ◽

...

Keyword(s):

Acute Lymphoblastic Leukemia ◽

Prognostic Value ◽

Lymphoblastic Leukemia ◽

Periodic Acid ◽

Childhood Acute Lymphoblastic Leukemia ◽

Periodic Acid Schiff

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Acute lymphoblastic leukemia with unusual cytoplasmic granulation: a morphologic, cytochemical, and ultrastructural study

Blood ◽

10.1182/blood.v68.2.406.406 ◽

1986 ◽

Vol 68 (2) ◽

pp. 406-411 ◽

Cited By ~ 13

Author(s):

J Fradera ◽

E Velez-Garcia ◽

JG White

Keyword(s):

Acute Lymphoblastic Leukemia ◽

Lymphoblastic Leukemia ◽

Periodic Acid ◽

Periodic Acid Schiff ◽

Acute Leukemias ◽

Ultrastructural Studies ◽

Sudan Black B ◽

Blast Cells ◽

Chediak Higashi Syndrome ◽

Schiff Reaction

Abstract The classification of the acute leukemias depends mainly on the morphologic and cytochemical evaluation of the blast forms. One of the main accepted morphologic criteria in the differentiation between acute lymphoblastic leukemia (ALL) and acute myeloblastic leukemia (AML) is the absence of granules in the blast cells of ALL. We evaluated a patient with ALL in whom granules were present in the cytoplasm of 35% of the blast cells, as seen in AML. Cytochemical evaluation was performed, including periodic acid-Schiff reaction, Sudan black B, alpha-naphthyl acetate, alpha-naphthyl butyrate, naphthol AS-D chloroacetate, and acid phosphatase stains. The results of these studies confirmed the morphologic impression and diagnosis of ALL. Ultrastructural evaluation revealed that the granules consisted of many tiny vesicles closely packed together in a proteinaceous matrix, resembling to some extent the inclusions described in lymphocytes in the Chediak-Higashi syndrome, but clearly different. The morphologic, cytochemical, and ultrastructural studies of this unique case are presented in detail. To our knowledge, this is the first time that such granules have been described in blast cells of ALL.

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The periodic acid-schiff reaction and prognosis in children with acute lymphoblastic leukemia

American Journal of Hematology ◽

10.1002/ajh.2830060105 ◽

1979 ◽

Vol 6 (1) ◽

pp. 27-34 ◽

Cited By ~ 7

Author(s):

R. Beverly Raney ◽

Robert S. Festa ◽

Maria T. G. Waldman ◽

David Manson ◽

Hie-Won L. Hann

Keyword(s):

Acute Lymphoblastic Leukemia ◽

Lymphoblastic Leukemia ◽

Periodic Acid ◽

Periodic Acid Schiff ◽

Schiff Reaction

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Near-haploid acute lymphoblastic leukemia: a unique subgroup with a poor prognosis?

Blood ◽

10.1182/blood.v58.1.14.bloodjournal58114 ◽

1981 ◽

Vol 58 (1) ◽

pp. 14-19 ◽

Cited By ~ 1

Author(s):

GM Brodeur ◽

DL Williams ◽

AT Look ◽

WP Bowman ◽

DK Kalwinsky

Keyword(s):

Acute Lymphoblastic Leukemia ◽

Dna Content ◽

Poor Prognosis ◽

Lymphoblastic Leukemia ◽

Periodic Acid ◽

Flow Cytometric Analysis ◽

Chromosome 21 ◽

Periodic Acid Schiff ◽

Flow Cytometric ◽

Block Pattern

We describe two adolescent girls with acute lymphoblastic leukemia (ALL) whose leukemia cells were near-haploid. Their lymphoblasts stained in a block pattern with periodic acid Schiff and had “common ALL” surface markers confirmed by indirect immunofluorescence. Each patient had two populations of blasts, one near-haploid and one hyperdiploid, which was an exact doubling of the near-haploid karyotype. The first patient had a predominant population of cells with 26 chromosomes and a few with 52, while the second had a predominance of cells with 56 and a minority with 28. Flow cytometric analysis of DNA content initially detected the minor near-haploid population in the second patient, which was confirmed later by cytogenetic review of the marrow sample. In addition to our two patients, only four patients have been reported with near-haploid ALL. Of these six, five were girls, five were adolescents, and five had short survivals (median, 10 mo). All six had disomy of chromosome 21 with or without disomy for chromosomes 10, 14, 18, or X (four patients each). Thus, near-haploid ALL may represent a unique subgroup of ALL with a poor prognosis. To detect these and other possible subgroups, we have included cytogenetic analysis and flow cytometric analysis of DNA content in our initial evaluation of patients with ALL.

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Near-haploid acute lymphoblastic leukemia: a unique subgroup with a poor prognosis?

Blood ◽

10.1182/blood.v58.1.14.14 ◽

1981 ◽

Vol 58 (1) ◽

pp. 14-19 ◽

Cited By ~ 61

Author(s):

GM Brodeur ◽

DL Williams ◽

AT Look ◽

WP Bowman ◽

DK Kalwinsky

Keyword(s):

Acute Lymphoblastic Leukemia ◽

Dna Content ◽

Poor Prognosis ◽

Lymphoblastic Leukemia ◽

Periodic Acid ◽

Flow Cytometric Analysis ◽

Chromosome 21 ◽

Periodic Acid Schiff ◽

Flow Cytometric ◽

Block Pattern

Abstract We describe two adolescent girls with acute lymphoblastic leukemia (ALL) whose leukemia cells were near-haploid. Their lymphoblasts stained in a block pattern with periodic acid Schiff and had “common ALL” surface markers confirmed by indirect immunofluorescence. Each patient had two populations of blasts, one near-haploid and one hyperdiploid, which was an exact doubling of the near-haploid karyotype. The first patient had a predominant population of cells with 26 chromosomes and a few with 52, while the second had a predominance of cells with 56 and a minority with 28. Flow cytometric analysis of DNA content initially detected the minor near-haploid population in the second patient, which was confirmed later by cytogenetic review of the marrow sample. In addition to our two patients, only four patients have been reported with near-haploid ALL. Of these six, five were girls, five were adolescents, and five had short survivals (median, 10 mo). All six had disomy of chromosome 21 with or without disomy for chromosomes 10, 14, 18, or X (four patients each). Thus, near-haploid ALL may represent a unique subgroup of ALL with a poor prognosis. To detect these and other possible subgroups, we have included cytogenetic analysis and flow cytometric analysis of DNA content in our initial evaluation of patients with ALL.

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Prognostic Value of the Periodic Acid-Schiff (PAS) Reaction in Acute Lymphoblastic Leukemia

American Journal of Clinical Pathology ◽

10.1093/ajcp/61.3.393 ◽

1974 ◽

Vol 61 (3) ◽

pp. 393-397 ◽

Cited By ~ 18

Author(s):

G. B. Humphrey ◽

M.E. Nesbit ◽

R. D. Brunning

Keyword(s):

Acute Lymphoblastic Leukemia ◽

Prognostic Value ◽

Lymphoblastic Leukemia ◽

Periodic Acid ◽

Periodic Acid Schiff ◽

Pas Reaction

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Acute lymphoblastic leukemia with unusual cytoplasmic granulation: a morphologic, cytochemical, and ultrastructural study

Blood ◽

10.1182/blood.v68.2.406.bloodjournal682406 ◽

1986 ◽

Vol 68 (2) ◽

pp. 406-411

Author(s):

J Fradera ◽

E Velez-Garcia ◽

JG White

Keyword(s):

Acute Lymphoblastic Leukemia ◽

Lymphoblastic Leukemia ◽

Periodic Acid ◽

Periodic Acid Schiff ◽

Acute Leukemias ◽

Ultrastructural Studies ◽

Sudan Black B ◽

Blast Cells ◽

Chediak Higashi Syndrome ◽

Schiff Reaction

The classification of the acute leukemias depends mainly on the morphologic and cytochemical evaluation of the blast forms. One of the main accepted morphologic criteria in the differentiation between acute lymphoblastic leukemia (ALL) and acute myeloblastic leukemia (AML) is the absence of granules in the blast cells of ALL. We evaluated a patient with ALL in whom granules were present in the cytoplasm of 35% of the blast cells, as seen in AML. Cytochemical evaluation was performed, including periodic acid-Schiff reaction, Sudan black B, alpha-naphthyl acetate, alpha-naphthyl butyrate, naphthol AS-D chloroacetate, and acid phosphatase stains. The results of these studies confirmed the morphologic impression and diagnosis of ALL. Ultrastructural evaluation revealed that the granules consisted of many tiny vesicles closely packed together in a proteinaceous matrix, resembling to some extent the inclusions described in lymphocytes in the Chediak-Higashi syndrome, but clearly different. The morphologic, cytochemical, and ultrastructural studies of this unique case are presented in detail. To our knowledge, this is the first time that such granules have been described in blast cells of ALL.

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