An in vitro B-cell colony assay system was used to evaluate B-cell differentiation from peripheral blood precursors in common acute lymphoblastic leukemia (cALL) patients in remission as compared to normal controls. Significant differences in the morphologic and phenotypic features of pooled colony cells were found between the two groups. The morphology and surface markers of control-cultured cells were those of young plasmocytes. In contrast, patients' cells had predominantly a lymphoblastoid appearance and a mean of 18% (2-72%) of the cells expressed the cALL (CALLA) antigen. This marker, known to be present on normal pre-B-cells and malignant cALL cells, was not found on control colony cells. Cytogenetic studies performed in four cases showed that a fraction of the patients' colony cells had karyotypic abnormalities similar to that of the original lymphoblasts. These data suggest that the cells with immature features persisting in the colonies of cALL patients are the progeny of residual circulating cells linked to the malignant clone which cannot be detected in the fresh sample and are clonally expanded during the culture.

Antigens, Differentiation↗

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Monitoring and treatment of minimal residual cancer of the prostate.

In manifest prostatic carcinoma, partial and complete remissions are obtained in 14-44% of patients as judged by different sets of criteria, but in up to 61% as judged by a decrease in prostatic acid phosphatase. Moreover, this decrease is poorly correlated to that of prostatic size. Prostatic acid phosphatase is therefore considered to be a relatively non-specific tumor marker. A complete remission, i.e. a stage of minimal residual disease, is obtained in about 25% of the patients. Continued endocrine treatment involves the risk of a flare-up of the disease, which is probably small. Additionally, in minimal residual disease, prolonged maintenance treatment requires minimization of side effects. D-Trp-6-LH-RH appears to lead to less gynecomastia and thromboembolism than some other forms of adjuvant therapy.

Adenocarcinoma↗

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Serum lipid-bound sialic acid as a tumoral marker in minimal residual tumors.

The lipid-associated sialic acid (LASA) level in serum was increased in 663 out of 794 patients (83.5%) of which 55.1% were CEA negative. There were 16.5% LASA (possibly false) negative, CEA positive patients. There were 24.1% false positives in 116 patients without malignant tumors. In manifest prostatic carcinoma 94.2% of the LASA values but only 36.5% of the prostatic acid phosphatase values were increased. Similarly, in breast and pulmonary carcinoma, LASA was more sensitive than CEA. In 499 patients with minimal residual disease, 203 (41.5%) were LASA-negative, of which 180 were CEA-negative. Out of 180 LASA positive patients, 70 have relapsed, as have 70 out of 219 patients with increases in both LASA and CEA. The sensitivity of LASA (87%) in lymphoma was higher than that of the erythrocyte sedimentation rate (53.3%), of C-reactive protein (51.2%), serum copper (64.7%) and of six other markers.

Biomarkers, Tumor↗

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Adjuvant treatment of minimal residual tumors. A comparison of chemotherapy and immunotherapy.

Adjuvant chemotherapy. The frequent 6 month complete remission induction chemotherapy is not discussed here. What is under debate at present is the prolonged maintenance or adjuvant chemotherapy, which in comparative trials with 5 year follow-up does not appear to improve survival prognosis in leukemia, myeloma, non-Hodgkin lymphoma or post-menopausal breast cancer. However, it may prolong the duration of the first remission. It is suggested that the sensitivity to chemotherapy might depend on cells being induced into the G2 or M phases by growth growth promotor(s), such as estrogens in breast carcinoma. Their presence before the menopause could explain why this neoplasia in this condition is one of the few tumoral diseases transitorily sensitive to adjuvant chemotherapy. Adjuvant immunotherapy is also under debate. Immunotherapy has been reported to give a significant improvement in remission duration and/or overall survival and/or survival after relapse in several tumors and in several trials. However, for almost every trial reporting a statistically significant effect there is one (or more) which shows no significant effect. Theoretically, immunotherapy has several advantages over chemotherapy. It may be effective in minimal residual disease if tumor cells are in the G0 phase. So-called kinetic refractoriness (see separate chapter in this volume) may not apply to immunotherapy. Finally, tumor cells appear to be more sensitive than normal cells to some cytotoxic mechanisms which form a part of the biological response to tumors.

Antineoplastic Agents↗

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[Does blastic crisis as revealed in chronic myeloid leukemia simulate either acute primary leukemia or acute primary leukemia with Philadelphia chromosome?].

In ten cases of apparently primary acute leukaemia, the discovery of a Philadelphia chromosome at routine examination of the caryotype led a diagnosis of blastic crisis of chronic myeloid leukemia. The clinical, cytological and cytogenetic pictures varied and only routine caryotypic examination may be used in reaching the diagnosis. The prognosis appear to be less bad than in blastic crises occurring after a long course of chronic myeloid leukaemia and closer to that of primary acute myeloid leukaemia.

Adolescent↗

PubMedDate not supplied

[Results of 3 protocols of treatment of acute lymphoid leukemia in children].

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Adolescent↗