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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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Submitted June 5, 2003
Accepted November 27, 2003

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 Revesz

Department of Pediatrics, Leiden University Medical Centre, Leiden, The Netherlands
Department of Immunology, Erasmus Medical Centre, Rotterdam, The Netherlands
Dutch Childhood Oncology Group, The Hague, The Netherlands
Department of Pathology, University Medical Centre, Utrecht, The Netherlands
Department of Pediatric Haematology and Stem Cell Transplantation, University Medical Centre, Utrecht, The Netherlands

* Corresponding author; email: n.e.annels{at}lumc.nl.

Childhood acute lymphoblastic leukaemia (ALL) is often associated with extramedullary infiltration by leukaemic cells at diagnosis or at relapse. To understand the mechanisms behind the dissemination of T-ALL cells this study investigated the homing receptor expression on the blast cells of 11 paediatric 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 these molecules are specifically associated with homing to the gut. This finding was clinically significant as the patient later suffered a relapse which was confined to the gut. Immunohistochemistry revealed that the leukaemic cells in the gut still expressed CCR9 and co-localized with a high expression of the CCR9 ligand, CCL25. These findings suggest that the original expression of CCR9 and CD103 on the leukaemic cells contributed to the relapse location in the gut of this patient.


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