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High‐degree abnormalities of nuclear DNA distribution in SIg negative acute lymphoblastic leukemia with vacuolated blasts
Author(s) -
Riccardi Alberto,
Montecucco Carlomaurizio,
Girino Margherita,
Danova Marco,
Ucci Giovanni,
Invernizzi Rosangela,
Ippoliti Giovanbattista,
Mazzini Giuliano,
Giordano Paolo,
Pasquali Francesco,
Ascari Edoardo
Publication year - 1986
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19861215)58:12<2632::aid-cncr2820581215>3.0.co;2-c
Subject(s) - pathology , vacuolization , lymph node , medicine , bone marrow , antibody , lymphoblast , acute lymphocytic leukemia , antigen , leukemia , immunology , biology , cell culture , lymphoblastic leukemia , genetics
Among 65 consecutive patients with untreated adult acute lymphoblastic leukemia (ALL), six had peculiar clinical and cytologic features. Bone marrow and circulating blasts were large and showed prominent vacuolization, with variable degree of granular periodic acid‐Schiff positivity in the cytoplasm. All patients had marked spleen and liver enlargement with cholestasis and without either lymph node or central nervous system disease. They achieved complete response to chemotherapy, and their median survival was longer than 12 months. Blast cells were studied for immunologic markers, propidium iodide flow cytofluorometric DNA content, and in vitro tritiated thymidine labeling index (3H‐TdR LI). These showed a “null” phenotype in two cases, contained intracytoplasmic immunoglobulins (Cyμ) in two and were positive for CALL and Ia antigens in two others (one of which also contained Cyμ). Surface immunoglobulins (SIg) were found on less than 12% of cells, and T‐cell markers were absent. In five cases, one or two stem lines with highly abnormal modal DNA content were found to coexist with diploid blasts. The 3H‐TdR LI was high (8.5%‐15.5%). Abnormal cell lines, after being cleared by chemotherapy, were found again at relapse. Additional cell lines appeared during the course of the disease in one patient, having different sensitivity to cytostatics. These cases of ALL apparently derive from B‐cells not yet expressing SIg and have an exceptionally high incidence of aneuploid cell lines.