acid-phosphatase and Mediastinal-Neoplasms

The prognostic significance of the immunological classification of ALL in children is described. While the prognosis of patients with the most frequent O- or common-ALL (frequency 70-85%) is comparatively good, prognosis of patients with T-ALL, which is most probably identical with acid phosphatase positive ALL,and with the rare B-ALL is worse. The therapeutic implications of the immunological classification is discussed.

Topics: Acid Phosphatase; Age Factors; B-Lymphocytes; Female; Humans; Leukemia, Lymphoid; Male; Mediastinal Neoplasms; Prognosis; Sex Factors; T-Lymphocytes

Ten cases of T-lymphoblastic lymphoma/leukemia were studied with light and electron microscopy. Cytochemical strains were performed on touch preparations, and mononuclear cell suspensions were tested for spontaneous rosette formation with sheep erythrocytes, C3 receptors, and surface immunoglobulins. The present investigation was performed to evaluate several ultrastructural parameters, mainly the nuclear shape, as diagnostic clues for this group of lymphomas. Characteristic convoluted nuclei were present in 7 to 47% of the lymphoblasts. This percentage correlated with the focal acid phosphatase reaction and E-rosette formation. Acid phosphatase was the best cytochemical marker (70-100% of the lymphoblasts showed focal reaction product). By ultrastructural cytochemistry, the reaction product was demonstrated in the Golgi cisternae and primary lysosomes. The cell suspensions obtained from different sources contained 14 to 95% E-rosette-forming cells. No specific morphologic, cytochemical, or immunologic differences were found between patients with or without mediastinal involvement.

Topics: Acid Phosphatase; Adolescent; Adult; Cell Nucleus; Child; Female; Humans; Leukemia, Lymphoid; Lymphoma; Male; Mediastinal Neoplasms; Middle Aged; Receptors, Antigen, B-Cell; Receptors, Complement; Rosette Formation; T-Lymphocytes

The initial bone marrow smeasrs of 821 children with ALL have been cytochemically analysed. (PAS-, acid phosphatase-(SPH), peroxydase-(POX), alpha-N-esterase-(EST)reaction) with regard to presenting clinical data and course of disease. Granular reactions of PAS and SPH were not meaningful in this respect. The paranuclear SPH-reaction was associated with high incidence of mediastinal mass, high peripheral blas count and male preponderance. All 5 patients with histories of more than 12 weeks duration belongs to the PAS-type of ALL (cloddy reaction). The PAS-type showed a higher incidence of CNS-leukaemia and generally a less favorable prognosis as compared to the UND-type. Thereby a high proportion of PAS positive cells, independently of other risk factors, indicates a better prognosis. The highterto neglected weak EST-reaction (Grad I and II according to Löffler) seems to signalise a clincally distinct subtype of ALL with a younger age distribution maximum as compared to the UND-type, low incidence of risk factors, high rate of remissions lasting more than 2 years but unfavorable endprognosis.

Topics: Acid Phosphatase; Age Factors; Aminosalicylic Acid; Bone Marrow; Bone Marrow Cells; Central Nervous System; Child; Child, Preschool; Esterases; Female; Histocytochemistry; Humans; Leukemia, Lymphoid; Male; Mediastinal Neoplasms; Peroxidases; Sex Factors; Time Factors

29 cases of T-cell derived lymphoblastic lymphoma and T-ALL have been analyzed. There is a striking prevalence of the male sex. In the peripheral blood we often find initially an excessive number of white blood cells combined with normal values for the other constituents in about half of the patients; This may be an expression for the rapid occurrence of leukaemia in T-cell lymphosarcoma. In addition to systemic ALL-therapy we performed X-ray irradiation of the mediastinum in 8 of our patients. This yielded to significantly longer first complete remissions. All patients with T-cell LSA/ALL with or without mediastinal mass should be treated in this manner. Cytochemically a strong focal acid phosphatase reaction was found to be acharacteristic of these cells. It has proved to be a screening method for this disease. The cells are T-cell derived and their pattern of surface markers is similar to that found in fetal thymocytes.

Topics: Acid Phosphatase; Adolescent; Age Factors; Child; Child, Preschool; Female; Histocytochemistry; Humans; Leukemia, Lymphoid; Lymphocytes; Lymphoma; Male; Mediastinal Neoplasms; Remission, Spontaneous; Sex Factors; T-Lymphocytes

Topics: Abdominal Neoplasms; Acid Phosphatase; Acute Disease; Aminosalicylic Acid; B-Lymphocytes; Child; Diagnosis, Differential; Humans; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid, Acute; Leukocytes; Mediastinal Neoplasms; Osteomyelitis; Paralysis; Rheumatic Diseases; Sepsis; T-Lymphocytes

Topics: Acid Phosphatase; Acute Disease; Alkaline Phosphatase; Carcinoma; Chronic Disease; Electrophoresis; Hot Temperature; Humans; Lymph Nodes; Mediastinal Neoplasms; Mediastinum; Sarcoidosis