True histiocytic lymphoma following therapy for lymphoblastic neoplasms

True histiocytic lymphomas (THLs) are rare tumors in which the malignant cells show morphologic and immunophenotypic evidence of histiocytic differentiation. We describe THLs that arose after therapy for one case of T-lineage lymphoblastic lymphoma (LyL) and two cases of acute lymphoblastic leukemia (ALL) (both CD10+, one pre-B phenotype). The lymphoblastic neoplasms were not unusual in any way, and responded well to standard therapy. The THLs arose 10 to 20 months after complete remission was achieved for the lymphoblastic neoplasms, at which time there was still no clinical or pathologic evidence of the lymphoblastic neoplasms. All three THLs exhibited clinical and morphologic features of malignancy. Neoplastic cells in the THLs had abundant eosinophilic vacuolated cytoplasm and pleomorphic nuclei, and expressed histiocytic antigens in the absence of lymphocyte-specific lineage markers. Because THLs are rare neoplasms, their occurrence after otherwise successful therapy for lymphoblastic neoplasms in these three cases may constitute a distinct clinicopathologic entity.

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Nelarabine induces complete remissions in adults with relapsed or refractory T-lineage acute lymphoblastic leukemia or lymphoblastic lymphoma: Cancer and Leukemia Group B study 19801

Blood ◽

10.1182/blood-2006-11-056754 ◽

2007 ◽

Vol 109 (12) ◽

pp. 5136-5142 ◽

Cited By ~ 168

Author(s):

Daniel J. DeAngelo ◽

Daohai Yu ◽

Jeffrey L. Johnson ◽

Steven E. Coutre ◽

Richard M. Stone ◽

...

Keyword(s):

Overall Survival ◽

Acute Lymphoblastic Leukemia ◽

T Cell ◽

Complete Remission ◽

Lymphoblastic Leukemia ◽

Disease Free Survival ◽

Lymphoblastic Lymphoma ◽

Level Of Consciousness ◽

Grade 3 ◽

Group B

AbstractNelarabine (506U78) is a soluble pro-drug of 9-β-d-arabinofuranosylguanine (ara-G), a deoxyguanosine derivative. We treated 26 patients with T-cell acute lymphoblastic leukemia (T-ALL) and 13 with T-cell lymphoblastic lymphoma (T-LBL) with nelarabine. All patients were refractory to at least one multiagent regimen or had relapsed after achieving a complete remission. Nelarabine was administered on an alternate day schedule (days 1, 3, and 5) at 1.5 g/m2/day. Cycles were repeated every 22 days. The median age was 34 years (range, 16-66 years); 32 (82%) patients were male. The rate of complete remission was 31% (95% confidence interval [CI], 17%, 48%) and the overall response rate was 41% (95% CI, 26%, 58%). The principal toxicity was grade 3 or 4 neutropenia and thrombocytopenia, occurring in 37% and 26% of patients, respectively. There was only one grade 4 adverse event of the nervous system, which was a reversible depressed level of consciousness. The median disease-free survival (DFS) was 20 weeks (95% CI, 11, 56), and the median overall survival was 20 weeks (95% CI, 13, 36). The 1-year overall survival was 28% (95% CI, 15%, 43%). Nelarabine is well tolerated and has significant antitumor activity in relapsed or refractory T-ALL and T-LBL.

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Meningeal Leukemia following Lymphoid Blast Crisis in Chronic Myeloid Leukemia: Therapeutic Implications

Tumori Journal ◽

10.1177/030089168206800311 ◽

1982 ◽

Vol 68 (3) ◽

pp. 257-263 ◽

Cited By ~ 1

Author(s):

Mario Cazzola ◽

Giulio Nalli ◽

Ercole Brusamolino ◽

Maurizio Daccò ◽

Angela Ghizzi ◽

...

Keyword(s):

Acute Lymphoblastic Leukemia ◽

Chronic Myeloid Leukemia ◽

Complete Remission ◽

Myeloid Leukemia ◽

Lymphoblastic Leukemia ◽

Blast Crisis ◽

Early Prevention ◽

Therapeutic Implications ◽

Therapeutic Protocol ◽

Meningeal Leukemia

Five of 40 patients with chronic myeloid leukemia (CML) had lymphoid blast crisis and 4 of them achieved complete remission of metamorphosis with vincristine and prednisone. While in hematologic remission, two of these subjects developed meningeal leukemia. Clinical and biologic data indicated that the course of the disease after lymphoid blast crisis was very similar to that of acute lymphoblastic leukemia (ALL). It is suggested that patients with CML who develop lymphoid blast crisis should be treated with an intensive therapeutic protocol including early prevention of meningeal leukemia.

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Allogeneic hematopoietic stem cell transplantation for adult patients with t(4;11)(q21;q23) KMT2A/AFF1 B-cell precursor acute lymphoblastic leukemia in first complete remission: impact of pretransplant measurable residual disease (MRD) status. An analysis from the Acute Leukemia Working Party of the EBMT

Leukemia ◽

10.1038/s41375-021-01135-2 ◽

2021 ◽

Author(s):

Jordi Esteve ◽

Sebastian Giebel ◽

Myriam Labopin ◽

Tomasz Czerw ◽

Depei Wu ◽

...

Keyword(s):

Stem Cell ◽

Acute Lymphoblastic Leukemia ◽

Complete Remission ◽

Residual Disease ◽

Lymphoblastic Leukemia ◽

Working Party ◽

Cell Precursor ◽

Hematopoietic Stem ◽

Measurable Residual Disease ◽

First Complete Remission

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Epoetin alpha decreases the number of erythrocyte transfusions in patients with acute lymphoblastic leukemia, lymphoblastic lymphoma, and Burkitt leukemia/lymphoma

Cancer ◽

10.1002/cncr.26341 ◽

2011 ◽

Vol 118 (3) ◽

pp. 848-855 ◽

Cited By ~ 15

Author(s):

Maria E. Cabanillas ◽

Hagop Kantarjian ◽

Deborah A. Thomas ◽

Gloria N. Mattiuzzi ◽

Michael E. Rytting ◽

...

Keyword(s):

Acute Lymphoblastic Leukemia ◽

Lymphoblastic Leukemia ◽

Lymphoblastic Lymphoma ◽

Epoetin Alpha

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Influence of detection of pretreatment cytogenetic abnormalities on first complete remission and survival in adult acute lymphoblastic leukemia

Turkish Journal of Hematology ◽

10.5152/tjh.2011.51 ◽

2011 ◽

Vol 28 (3) ◽

pp. 176-185

Author(s):

Milena Georgieva Velizarova ◽

Evgueniy A. Hadjiev ◽

Kamelia V. Alexandrova ◽

Ivanka I. Dimova ◽

Draga I. Toncheva ◽

...

Keyword(s):

Acute Lymphoblastic Leukemia ◽

Complete Remission ◽

Lymphoblastic Leukemia ◽

Cytogenetic Abnormalities ◽

Adult Acute Lymphoblastic Leukemia ◽

First Complete Remission

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No difference in outcome between children and adolescents transplanted for acute lymphoblastic leukemia in second remission

Blood ◽

10.1182/blood-2011-05-354233 ◽

2011 ◽

Vol 118 (25) ◽

pp. 6683-6690 ◽

Cited By ~ 26

Author(s):

Giorgio Dini ◽

Marco Zecca ◽

Adriana Balduzzi ◽

Chiara Messina ◽

Riccardo Masetti ◽

...

Keyword(s):

Acute Lymphoblastic Leukemia ◽

Complete Remission ◽

Confidence Interval ◽

Children And Adolescents ◽

Lymphoblastic Leukemia ◽

Disease Recurrence ◽

Hematopoietic Stem ◽

Free Survival ◽

Total Body ◽

Related Mortality

Abstract Acute lymphoblastic leukemia (ALL) in second complete remission is one of the most common indications for allogeneic hematopoietic stem cell transplantation (HSCT) in pediatric patients. We compared the outcome after HCST of adolescents, aged 14 to 18 years, with that of children (ie, patients < 14 years of age). Enrolled in the study were 395 patients given the allograft between January 1990 and December 2007; both children (334) and adolescents (61) were transplanted in the same pediatric institutions. All patients received a myeloablative regimen that included total body irradiation in the majority of them. The donor was an HLA-identical sibling for 199 patients and an unrelated volunteer in the remaining 196 patients. Children and adolescents had a comparable cumulative incidence of transplantation-related mortality, disease recurrence, and of both acute and chronic graft-versus-host disease. The 10-year probability of overall survival and event-free survival for the whole cohort of patients were 57% (95% confidence interval, 52%-62%) and 54% (95% confidence interval, 49%-59%), respectively, with no difference between children and adolescents. This study documents that adolescents with ALL in second complete remission given HSCT in pediatric centers have an outcome that does not differ from that of patients younger than 14 years of age.

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Outcome of Allogeneic Hematopoietic Stem-Cell Transplantation in Adult Patients With Acute Lymphoblastic Leukemia: No Difference in Related Compared With Unrelated Transplant in First Complete Remission

Journal of Clinical Oncology ◽

10.1200/jco.2004.07.130 ◽

2004 ◽

Vol 22 (14) ◽

pp. 2816-2825 ◽

Cited By ~ 152

Author(s):

Michael G. Kiehl ◽

Ludwig Kraut ◽

Rainer Schwerdtfeger ◽

Bernd Hertenstein ◽

Mats Remberger ◽

...

Keyword(s):

Bone Marrow ◽

Stem Cell ◽

Acute Lymphoblastic Leukemia ◽

Complete Remission ◽

Stem Cell Transplantation ◽

Cell Transplantation ◽

Lymphoblastic Leukemia ◽

Philadelphia Chromosome ◽

Hematopoietic Stem ◽

First Complete Remission

Purpose The role of unrelated allogeneic stem-cell transplantation in acute lymphoblastic leukemia (ALL) patients is still not clear, and only limited data are available from the literature. We analyzed factors affecting clinical outcome of ALL patients receiving a related or unrelated stem-cell graft from matched donors. Patients and Methods The total study population was 264 adult patients receiving a myeloablative allogeneic stem-cell transplant for ALL at nine bone marrow transplantation centers between 1990 and 2002. Of these, 221 patients receiving a matched related or unrelated graft were analyzed. One hundred forty-eight patients received transplantation in complete remission; 62 patients were in relapse; and 11 patients were refractory to chemotherapy before transplant. Fifty percent of patients received bone marrow, and 50% received peripheral blood stem cell from a human leukocyte antigen–identical related (n = 103), or matched unrelated (n = 118) donor. Results Disease-free survival (DFS) at 5 years was 28%, with 76 patients (34%) still alive (2.2 to 103 months post-transplantation), and 145 deceased (65 relapses, transplant-related mortality, 45%). We observed an advantage regarding DFS in favor of patients receiving transplantation during their first complete remission (CR) in comparison with patients receiving transplantation in or after second CR (P = .014) or who relapsed (P < .001). We observed a clear trend toward improved survival in favor of B-lineage ALL patients compared with T-lineage ALL patients (P = .052), and Philadelphia chromosome–positive patients had no poorer outcome than Philadelphia chromosome–negative patients. Total-body irradiation–based conditioning improved DFS in comparison with busulfan (P = .041). Conclusion Myeloablative matched related or matched unrelated allogeneic hematopoietic stem-cell transplantation in ALL patients should be performed in first CR.

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