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Heterogeneity of presenting features and their relation to treatment
outcome in 120 children with T-cell acute lymphoblastic leukemia
CH Pui, FG Behm, B Singh, MJ Schell, DL Williams, GK Rivera, DK Kalwinsky, JT Sandlund, WM Crist and SC Raimondi
Department of Hematology-Oncology, St Jude Children's Research Hospital,
Memphis, TN 38101.
Presenting features of 120 consecutive children with T-cell acute
lymphoblastic leukemia (ALL), representing 15% of all patients diagnosed as
having ALL during the study period, were analyzed to determine
relationships with treatment outcome. Patients' ages ranged from 1.7 to
18.8 years (median, 10.3 years) and their leukocyte counts from 1.7 to
1,070 x 10(9)/L (median, 100 x 10(9)/L). Central nervous system (CNS)
leukemia was present in 12.5% of the cases, a mediastinal mass in 61%, and
L2 lymphoblast morphology in 32%. A relatively high proportion of cases,
26%, had normal karyotypes at presentation. Of the cases tested, membrane
CD1 expression was found in 38% of cases, CD3 in 33%, CD4 in 50%, CD5 in
94%, CD8 in 55%, and CD10 in 35%. Four presenting features were found to
confer an increased risk of treatment failure: age greater than or equal to
15 years, L2 lymphoblast morphology, abnormal karyotype, and membrane CD3
expression. This study illustrates the heterogeneity of presentations of
childhood T-cell ALL and suggests that the relative importance of risk
factors in ALL differs according to immunophenotype and treatment strategy.
Volume 75,
Issue 1,
pp. 174-179,
01/01/1990
Copyright © 1990 by The American Society of Hematology
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