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Vascular density in childhood acute lymphoblastic leukaemia correlates to biological factors and outcome
Author(s) -
NorénNyström Ulrika,
Heyman Mats,
Frisk Per,
Golovleva Irina,
Sundström Christer,
Porwit Anna,
Roos Göran,
Bergh Anders,
Forestier Erik
Publication year - 2009
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.2009.07796.x
Subject(s) - medicine , acute lymphocytic leukemia , lymphoblastic leukemia , oncology , pediatrics , leukemia
Summary The issue of angiogenesis and its clinical relevance in childhood acute lymphoblastic leukaemia (ALL) is controversial. In the present study, microvessel density (MVD), analysed in 185 diagnostic bone marrow biopsies, was higher in T‐cell ALL compared to B‐cell precursor (BCP)‐ALL ( P = 0·013). In the BCP group, cases with t(12;21) were characterized by a low MVD while patients with high‐hyperdiploid leukaemia (HeH, 51–61 chromosomes) showed a high MVD compared to other BCP patients ( P = 0·001 and 0·002 respectively). There was a correlation between MVD and white blood cell (WBC) count in high‐risk BCP patients ( P = 0·021). In addition, BCP patients with a high marrow reticulin fibre density and high MVD had an unfavourable outcome compared to the other BCP patients ( P = 0·002). The fraction of vessels in which lumina were filled with blasts (blast congested vessel fraction) correlated strongly with WBC count ( P < 0·001). These findings indicate that the angiogenic process interacts with other stroma‐factors, such as reticulin fibre density, in its effect on outcome, and is coupled to both the ALL genotype and phenotype. One possible implication is that different subtypes of childhood ALL may respond differently to anti‐angiogenic drugs as a supplement in first‐line treatment.