Prognostic Evaluation of Acute Lymphoblastic Leukemia by Immunologic Markers

Abstract

Leukemic blasts from 128 consecutive patients (68 children and 60 adults) with acute lymphoblastic leukemia(ALU were tested in each case for the following surface markers: sheep erythrocyte receptortf.-R), TI0 antigerul l O), surface membrane immunoglobulin(Smlg) and common' ALL antigen(CALLA). A clear distinction of 5 subgroups of patients with ALL was possible: (1) common null-cell or cALUCALLA+) in 47 patients; (2) intermediate-cell or ciT ALL (CALLA+, TI0+) in 29 patients; (3) T-cell or T-ALUE-R -: in 21 patients; (4) null-cell or null ALL in 29 patients; and (5) 8-cell or B-ALL (Srnlg-j ) in 2 patients. Particular emphasis was put on the subgroup with TI0 expression together with CALLA. An analysis of clinical data at presentation revealed significant differences for white-cell count, age distribution and organomegaly between cALL and ciT ALL. There were also significant differences in freuqencies of remission induction and survival rate between cALL and ciT ALL. TI0 positivity is a poor prognostic factor in common ALL. We evaluated prognostic significance of the markers by univariate and multivariate survival analysis and concluded that a combined use of the markers is essential to reach a precise diagnosis of subgroups of ALL with different biologic and prognostic characteristics.