Significance of aberrant immunophenotypes in childhood acute lymphoid leukemia

Article Abstract:

The development of monoclonal antibody technology has opened new avenues for the examination of leukemia cells. This technology permits the growth in the laboratory of extremely pure antibodies that are highly specific for various cellular proteins. As a result of the availability of these antibody reagents, it is possible to examine leukemic cells for the presence of different antigens, such as normal T cell antigens, normal B cell antigens, and normal myeloid cell antigens. Generally, a pattern of consistent antigen expression is considered to be ''conventional'' for leukemic cells. For example, if a leukemic cell expresses antigens that are all related to the heritage of T cells, the expression is conventional. No normal cell is known to have both T cell and B cell antigens, and thus a leukemic cell that has both is said to be aberrant (abnormal). A study was conducted to determine if the expression of various antigens on leukemic cells provides insight into the natural history and course of acute lymphoid leukemia. Fifty-one patients were studied, all of whom were under 18 years of age. The breakdown was roughly half-and-half, with 26 patients having conventional antigen expression and 25 having aberrant expression. Analysis of the survival times and other disease characteristics revealed no correlation with either conventional or aberrant antigen expression. Two correlations emerged, however, when only the expression of myeloid antigens was considered. (Myeloid antigens are antigens expressed on cells of the bone marrow.) Patients whose leukemic cells expressed myeloid antigens had remissions after their first course of treatment that lasted an average of 26 months; the patients whose cells did not have these antigens experienced initial remissions that averaged 40 months. The survival times were also influenced by this factor: 27 and 62 months for myeloid-antigen-positive and myeloid-antigen-negative cells, respectively. Pediatric patients with acute lymphoid leukemia whose cells express myeloid antigens may constitute an especially high-risk group. (Consumer Summary produced by Reliance Medical Information, Inc.)

Analysis, Physiological aspects, Antigenic determinants, Acute lymphocytic leukemia, Childhood leukemia, Immunospecificity, Lymphocytic leukemia in children

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Amsacrine is safe and effective therapy for patients with myocardial dysfunction and acute leukemia

Article Abstract:

Drugs such as doxorubicin and daunorubicin play an important role in the treatment of leukemia and other cancers. However, these drugs, members of the anthracycline class, can cause particularly serious toxic effects, the most notable being serious damage to the heart muscle. Due to the high risk of heart failure, these drugs are not suitable for use in patients who have experienced a relapse of cancer. Similarly, these drugs may not be appropriate for patients suffering heart problems from other causes. A study was conducted to determine if the anticancer drug amsacrine might be safe and effective for use in patients for whom further anthracycline treatment is not appropriate. A total of 305 patients who had previously been treated for acute leukemia were evaluated. These patients had either relapsed after treatment or failed to respond to initial therapy. Among the 305 patients, 24 patients were found to have reduced left ventricular ejection fraction (LVEF). Reduced LVEF indicates that a smaller than normal amount of blood is being expelled from the heart with each beat; this measurement is a physiological indicator that the heart muscle is not functioning normally. These 24 patients were treated with amsacrine and high-dose cytosine arabinoside (cytarabine). Nine of the 24 patients achieved a complete remission. The treatment caused a significant reduction in LVEF in only two patients. In seven patients, the LVEF actually increased. Six additional patients were treated with the amsacrine and cytarabine protocol; these patients had not been treated previously. They suffered from heart conditions that prevented the use of the standard protocol. Four of the six patients experienced complete remissions. The results of this study indicate that amsacrine is safe and effective in the treatment of patients with acute leukemia and heart disease. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Chemotherapy, Acute leukemia, Amsacrine

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