acid-phosphatase and Precursor-Cell-Lymphoblastic-Leukemia-Lymphoma

Special stains are used in the evaluation of bone marrow specimens to augment Wright-Giemsa preparations. This article details the common cytochemical stains available, and discusses their clinical use as indicators of hematopoietic lineage. Iron and reticulin stains, which are widely used in the general evaluation of the bone marrow, are also reviewed.

Topics: Acid Phosphatase; Alkaline Phosphatase; Coloring Agents; Humans; Leukemia, Myeloid, Acute; Peroxidase; Precursor Cell Lymphoblastic Leukemia-Lymphoma

We have previously reported that the phorbol ester, 12-O-tetradecanoylphorbol 13-acetate (TPA) induces further differentiation of the human acute lymphoblastic leukemia cell line Reh to a monocytoid B lymphocyte stage. In the present study, we investigated the differentiating capacity of another protein kinase C (PKC) activator, bryostatin 1 (bryo). Reh cells were treated in vitro with TPA, bryo, or interferon-alpha (IFN-alpha) for a period of 5 days during which cells were analyzed for changes in growth patterns, morphology, cytochemistry, and surface phenotype. Bryo caused a dose-dependent growth inhibition of Reh cells. Morphologically, the treated cells expressed monocytoid features with development of filopodia and numerous vacuoles indicating phagocytic activity. Bryo induced similar phenotypic changes to TPA, including induction of CD11c, increased expression of CD22 and down-regulation of CD10 and CD19. Enzymatically, bryo, like TPA, induced tartrate-sensitive acid phosphatase expression but failed to induce periodic acid Schiff (PAS) and nonspecific esterase (NSE). Bryo inhibited the TPA action on NSE and CD10. IFN-alpha showed additive growth inhibitory and phenotypic effects to bryo. Collectively, our findings indicate that bryo is capable of inducing further differentiation of the Reh cells along the B cell lineage similar to those of TPA.

Topics: Acid Phosphatase; Antigens, CD; Antineoplastic Agents; B-Lymphocytes; Bryostatins; Carboxylesterase; Carboxylic Ester Hydrolases; Cell Differentiation; Cell Division; Humans; Lactones; Macrolides; Microscopy, Electron; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Tetradecanoylphorbol Acetate; Tumor Cells, Cultured

Between 1983-1988 bone marrow samples obtained from 195 peroxidase-negative leukemia patients were analyzed for their surface antigens. Thirteen of these patients (6.7%) had myelomonocytic-positive and lymphoid-negative antigens. These leukemic cells reacted with CD13 in eight patients, CD33 in seven, CD11 in six and CDw41 in two. In none of these patients did the leukemic cells react with CD1, CD2, CD3, CD4, CD5, CD8, CD10, CD19 or CD20. Leukemic cells from two patients were reactive with CD7. These leukemic cells demonstrated L2 morphology in 11 patients and L1 morphology in one patient. The leukemic cells from the final patient were diagnosed as those of leukemic transformation of myelodysplastic syndrome. Chromosomal abnormality was observed in approximately half of the patients examined (6/10). Cytochemical analysis revealed that the leukemic cells were negative for periodic acid Schiff stain but positive for acid phosphatase. The prognosis of these patients was markedly poor as compared to acute lymphocytic leukemia or typical peroxidase-positive nonlymphocytic leukemia. Complete remission was induced in only 30% of patients and duration of survival was short (4.7 months). This suggests that myelomonocytic antigen-positive peroxidase-negative acute leukemia is a distinct type of leukemia and may require more aggressive therapy to improve survival.

Topics: Acid Phosphatase; Adolescent; Adult; Aged; Antigens, CD; Antigens, Neoplasm; Antineoplastic Combined Chemotherapy Protocols; Biomarkers, Tumor; Bone Marrow Examination; Carboxylesterase; Carboxylic Ester Hydrolases; Child; Chromosome Aberrations; Female; Hematopoietic Stem Cells; Humans; Immunophenotyping; Infant; Leukemia, Myeloid, Acute; Male; Middle Aged; Neoplasm Proteins; Neoplastic Stem Cells; Periodic Acid-Schiff Reaction; Peroxidase; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Prognosis

Ecto-5'-nucleotidase (ecto-5'NT) catalyzes the extracellular dephosphorylation of nucleotides like IMP. Cytoplasmic 5'NT (cyto-5'NT) and non-specific (e.g. acid- and alkaline) phosphatases (AP) regulate the intracellular degradation of nucleotides. High NT and AP activities might cause a resistance to the thiopurines 6-mercaptopurine (6-MP) and 6-thioguanine (6-TG). We studied the relation between these enzymes and immunophenotype, drug resistance and prognosis in 77 children with acute lymphoblastic leukemia (ALL). Enzyme activities were assessed radiochemically; in vitro drug resistance was measured with the MTT assay. AP activities were higher in T-ALL and B-ALL than in precursor B-ALL. Cyto-5'NT activity was very low in all phenotypes and accounted for a significant proportion of total IMPase activity only in the very immature CD10- c mu- precursor B-ALL. CD10+ ALL cases with high ecto-5'NT activities showed a trend (p = 0.065) for a lower probability of continuous complete remission than those with a low activity. Ecto-5'NT activity was not related to in vitro drug resistance to 6-TG. A weak correlation was found between in vitro 6-TG resistance and cyto-5'NT and AP activities. We conclude that high ecto-5'NT activities do not cause a resistance to 6-thiopurines in childhood ALL. Some patients have high cyto-5'NT and AP activities associated with 6-thiopurine resistance.

Topics: 5'-Nucleotidase; Acid Phosphatase; Adolescent; Alkaline Phosphatase; Antineoplastic Combined Chemotherapy Protocols; Asparaginase; Child; Child, Preschool; Daunorubicin; Drug Resistance; Female; Humans; Immunophenotyping; Infant; Leukemia, B-Cell; Male; Mercaptopurine; Methotrexate; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Prednisone; Prognosis; Vincristine

Stromal cell numbers from subjects with no haematological disease and those with acute myeloid leukaemia (AML), chronic granulocytic leukaemia (CGL), acute lymphatic leukaemia (ALL) and non-Hodgkin's lymphoma (NHL) were compared to determine their role in malignancy. Frozen sections of trephine biopsy specimens from iliac crests were stained for endogenous alkaline phosphatase activity, endogenous acid phosphatase activity, and, using immunocytochemical methods, for endothelial cells (anti-factor-VIII related antigen) and macrophages and related cells (EBM/11). In granulocytic malignancies, whether acute or chronic, alkaline phosphatase positive reticulum cells (AL-RC) and vascular endothelial cells were generally increased. In lymphoid malignancies, the numbers of AL-RC were generally reduced. Numbers of vascular endothelial cells seemed to be normal in ALL but reduced in foci of NHL. Macrophages are numerous in normal marrow, and their numbers seemed to be normal in granulocytic lesions but were more variable and sometimes reduced in ALL and NHL. Lymphoid malignancies, therefore, have a destructive effect on some stromal elements; granulocytic malignancies are associated with normal or increased numbers of stromal cells. A possible consequence of depleted stromal cells might be slower reconstitution of normal haemopoiesis after treatment. The large numbers in granulocytic malignancies raises the possibility of synergistic stimulation between stromal and neoplastic cells.

Topics: Acid Phosphatase; Adult; Aged; Alkaline Phosphatase; Bone Marrow; Cell Count; Endothelium, Vascular; Female; Humans; Leukemia, Myelogenous, Chronic, BCR-ABL Positive; Leukemia, Myeloid; Lymphoma, Non-Hodgkin; Macrophages; Male; Middle Aged; Precursor Cell Lymphoblastic Leukemia-Lymphoma

We describe eight patients (four children and four adults) with an acute lymphoblastic leukaemia (ALL) with cytoplasmic granules or inclusions. The incidence of this variant of acute leukaemia in our whole series of patients with ALL is 1.8%. The granules or inclusions were usually positive for aspecific esterases (ANAE) and/or acid phosphatase, and the immunophenotype was in all cases typical of a CALLA positive B-lineage ALL (CD10+, CD19+ and/or CD24+, DR+, TdT+, anti-T-, anti-My-, SIg-). In one paediatric case, CD33 was unusually coexpressed. Ultrastructural investigations were performed in one case and demonstrated large granules containing vesicles, usually membrane bound, in the majority of blast cells. In the two cases analysed, Ig heavy chain gene rearrangement was detected. In this series of patients prognosis was poor since three never achieved a complete remission, four relapsed and only one is still in first continuous remission.

Topics: Acid Phosphatase; Adult; Bone Marrow; Child; Cytoplasmic Granules; Female; Humans; Male; Microscopy, Electron; Middle Aged; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Prognosis

The activity of serum acid phosphatase (AP), bone marrow lymphoblasts and polymorphonuclear neutrophils was studied in 45 ALL patients. Cytochemical coefficients (CCC) and the percentage of positively reacting bone marrow cells were determined. All the patients received programmed polychemotherapy. They were investigated before the start of therapy, during recurrence and at different time of remission (from 1 to 60 mos) during each reinduction cycle. At the climax of ALL the activity of serum AP was increased 2.8-fold, a CCC value for lymphoblastic AP--10-fold, for polymorphonuclear neutrophils--3-fold as compared with normal values. A tendency toward the reduction of indices was noted at different time of remission, the approximation to normal values was noted on the 40th-46th months of remission only. In recurrence development the level of the serum and cellular enzyme as well as the percentage of positively reacting cells significantly exceeded normal values and were close to indices at the climax of disease. The above tendency permitted the use of these tests to evaluate the completeness of remission and to predict recurrences during a follow-up of ALL patients.

Topics: Acid Phosphatase; Antineoplastic Combined Chemotherapy Protocols; Bone Marrow; Clinical Enzyme Tests; Female; Histocytochemistry; Humans; Lymphocytes; Male; Neutrophils; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Prognosis; Recurrence; Remission Induction

We describe two childhood cases of a T-cell malignancy indistinguishable from nonendemic, idiopathic adult T-cell leukemia/lymphoma. The cases illustrate the heterogeneity of nonendemic, idiopathic ATLL, including the presence of mediastinal masses and more heterogeneous immunologic markers than endemic cases, and represent the two youngest cases of ATLL yet described. The differential diagnosis of nonendemic, idiopathic ATLL is discussed.

Topics: Acid Phosphatase; Adolescent; Biomarkers; Bone Marrow; Child; Diagnosis, Differential; Female; Humans; Karyotyping; Leukemia-Lymphoma, Adult T-Cell; Lymph Nodes; Male; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Skin