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Evidence for clonal development of childhood acute lymphoblastic leukemia
LW Dow, P Martin, J Moohr, M Greenberg, LG Macdougall, V Najfeld and PJ Fialkow
To determine whether acute lymphoblastic leukemia (ALL) is a clonal disease
and to define the pattern of differentiation shown by the involved
progenitor cells, we studied the glucose-6-phosphate dehydrogenase (G6PD)
types in the cells of 19 girls heterozygous for this X chromosome-linked
enzyme. Lymphoblast immunophenotypes were those of HLA-DR+, CALLA+ ALL (six
patients); HLA-DR+, CALLA- ALL (four patients); pre-B cell ALL (two
patients); T cell ALL (four patients); and undefined ALL (three patients).
Malignant blast cells at diagnosis from ten patients displayed a single
G6PD type, indicative of clonal disease. In contrast, both A and B G6PD in
ratios similar to those found in skin were observed in morphologically
normal blood cells from the same patients. The leukemic cells of three
patients were examined at both diagnosis and relapse; in each instance the
same G6PD type was found, consistent with regrowth of the original leukemic
clone at relapse. Results of studies of cells from nine additional patients
tested only at relapse were similar. Our results indicate that childhood
ALL is a clonally derived disease involving progenitor cells with
differentiation expression detected only in the lymphoid lineage.
Volume 66,
Issue 4,
pp. 902-907,
10/01/1985
Copyright © 1985 by The American Society of Hematology
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