lewis-x-antigen and Blast-Crisis

The abnormality in the translocation of chromosomes 4 and 11 (t[4;11]) has been characteristically associated with calla-negative CD15(+) acute lymphoblastic leukemia (ALL) of early pre-B-cell origin. Transformation of a lymphoblastoid to a monoblastoid morphologic structure has rarely been described at relapse in these cases; however, these cases have lacked flow cytometric immunophenotyping (FCI) and genotypic studies (GS) to define the immunophenotype of and the presence of a B-cell gene rearrangement in the monoblastoid component. We report a case of CD15(+), CD10(-) ALL of early pre-B-cell origin defined by morphologic testing and FCI with the t(4;11) abnormality. At relapse, the morphologic testing, enzyme cytochemistry, and FCI data were characteristic of monoblastic leukemia. The t(4;11) abnormality persisted with associated additional chromosomal abnormalities, and the monoblasts contained a B-cell gene rearrangement by GS. These findings support the concept that both processes arose from a multipotential progenitor cell.

Topics: Antigens, CD; B-Lymphocytes; Blast Crisis; Bone Marrow Transplantation; Chromosome Mapping; Chromosomes, Human, Pair 11; Chromosomes, Human, Pair 4; Female; Flow Cytometry; Gene Rearrangement, B-Lymphocyte; Humans; Immunoglobulin Heavy Chains; Immunophenotyping; Leukemia, Monocytic, Acute; Lewis X Antigen; Middle Aged; Neoplasms, Second Primary; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Translocation, Genetic

Bone marrows from 30 newly diagnosed Ph+chronic myelocytic leukemia (CML) (21 in chronic phase, CML-CP, 9 in accelerate phase, CML-AP) and 8 followed up patients in blast crisis (CML-BC) were tested by DNA strand breaks (%D value), DNA-aneuploidy, flow cytometry-cell surface antigen expression for CD15 and HLA-DR ratio. Our results showed that all these three parameters changed as the disease escalated. A very low value of %D and DNA-aneuploidy occurrences were high risk factors. Cell surface antigen expression CD15 and HLA-DR ratio measurement was simple and reliable. The ratio < 1.0 appeared earlier than morphology clarifying CML-AP and should be followed up regularly.

Topics: Aneuploidy; Antigens, CD; Antigens, Differentiation, Myelomonocytic; Biomarkers, Tumor; Blast Crisis; DNA Damage; DNA, Neoplasm; Flow Cytometry; HLA-DR Antigens; Humans; Leukemia, Myelogenous, Chronic, BCR-ABL Positive; Lewis X Antigen; Prognosis; Risk Factors

The distribution of peanut agglutinin (PNA) receptors, nonspecific cross-reacting antigen (NCA) molecule and 3-fucosyl-N-acetyllactosamine (FAL) in myeloid leukemic cells isolated by density gradient centrifugation was compared using immunofluorescence test (IF). Patients with acute myelocytic leukemias (AML) type M2 and M5 showed low percentage of NCA+ and PNA+ cells. In chronic and acute phase of chronic myelocytic leukemias (CML) the number of NCA containing cells increased and the amount of PNA-binding cells decreased as more mature granulocytic fractions were isolated on Ficoll--Uropoline density gradient. In patients with myeloblastic crisis of CML (CML-BC) the number of cells expressing FAL structure did not change in relation to maturation stage of myeloid cells. Our results revealed that the expression of various markers could change in a different way during the differentiation of cells from myeloblasts to mature granulocytes.

Topics: Antigens, Neoplasm; Blast Crisis; Cell Adhesion Molecules; Cell Differentiation; Fluorescent Antibody Technique; Glycoproteins; Humans; Leukemia, Myeloid, Acute; Leukocytes; Lewis X Antigen; Receptors, Mitogen

The phenotypic marker profile of a case of acute leukemia is described; its immunophenotype is unique in that the blast cells were initially negative for a wide panel of monoclonal antibodies (McAbs) to surface and intracytoplasmic antigens and for the nuclear enzyme terminal deoxynucleotidyl transferase. Morphological and cytochemical examination suggested an acute myeloid leukemia (AML), but the cells were unreactive with anti-myeloid McAbs. Treatment with the phorbol ester 12-O-tetradecanoylphorbol 13-acetate (TPA) induced the cells to differentiate morphologically to macrophage-like cells and led to the expression of surface antigens that could be detected by antimyeloid McAbs. It is not clear whether these cells represent a rare subclass of leukemic cells that are void of any characteristic surface markers but have the potential to differentiate along the myeloid axis, or whether the antigens were masked by an unknown process.

Topics: Acute Disease; Aged; Antibodies, Monoclonal; Antigens, Neoplasm; Antigens, Surface; Blast Crisis; Cells, Cultured; Flow Cytometry; Fluorescent Antibody Technique; Humans; Hybridization, Genetic; Leukemia; Leukemia, Myeloid, Acute; Lewis X Antigen; Lymphocytes; Male; Neuraminidase; Phenotype; Tetradecanoylphorbol Acetate