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Blood, 1 April 2004, Vol. 103, No. 7, pp. 2806-2808.
Prepublished online as a Blood First Edition Paper on December 4, 2003; DOI 10.1182/blood-2003-06-1812.


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NEOPLASIA
Brief report

Possible link between unique chemokine and homing receptor expression at diagnosis and relapse location in a patient with childhood T-ALL

Nicola E. Annels, Annemieke J. Willemze, Vincent H. J. van der Velden, Claudia M. J. M. Faaij, Elisabeth van Wering, Daisy M. D. S. Sie-Go, R. Maarten Egeler, Maarten J. D. van Tol, and Tom Révész

From the Department of Paediatrics, Division of Immunology, Haematology, Oncology, Bone Marrow Transplantation and Autoimmune Diseases, Leiden University Medical Centre (LUMC), Leiden, the Netherlands; the Department of Immunology, Erasmus Medical Centre, Rotterdam, the Netherlands; the Dutch Childhood Oncology Group (DCOG), The Hague, the Netherlands; the Department of Pathology, University Medical Centre, Utrecht, the Netherlands; and the Department of Paediatric Haematology and Stem Cell Transplantation, University Medical Centre, Utrecht, the Netherlands.

Childhood acute lymphoblastic leukemia (ALL) is often associated with extramedullary infiltration by leukemic cells at diagnosis or at relapse. To understand the mechanisms behind the dissemination of T-cell ALL (T-ALL) cells this study investigated the homing receptor expression on the blast cells of 11 pediatric T-ALL patients at diagnosis. One patient revealed a unique profile with high expression of the chemokine receptor CCR9 and the integrin CD103 on the T-ALL cells. Both of these molecules are specifically associated with homing to the gut. This finding was clinically significant as the patient later suffered a relapse that was confined to the gut. Immunohistochemistry revealed that the leukemic cells in the gut still expressed CCR9 and colocalized with a high expression of the CCR9 ligand, CCL25. These findings suggest that the original expression of CCR9 and CD103 on the leukemic cells contributed to the relapse location in the gut of this patient. (Blood. 2004;103:2806-2808)


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