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PubMed1988

Infantile acute leukemia with 11q23 chromosome abnormality and lineage infidelity.

An infant case of acute leukemia (AL) showed lineage infidelity and a chromosome rearrangement involving 11q23. This case was morphologically diagnosed as ALL-L2 according to the FAB classification. However, the blast cells were highly positive for monoclonal antimyeloid antigens (Mol and TG-8) and lymphoid markers (B1, J5 and TdT). These immunologic findings indicated that the blast cells had characteristics of lymphoid B-cell and myeloid lines. In the literature, so-called "11q23 chromosome abnormalities," commonly observed in acute nonlymphoblastic leukemia (ANLL) and in a subtype of acute lymphoblastic leukemia (ALL) with t(4;11) were observed in both lymphoid and myeloid acute leukemias, with some of them recently reported to have lineage infidelity. These unique characteristics may indicate the possibility that the latter is a variation of the former, and support the hypothesis that the chromosomal rearrangement at 11q23 occurs at a multipotent stem-cell level.

Acute Disease↗

PubMed2026

Tumour-infiltrating lymphocytes differ across MammaPrint® classifications in breast cancer.

MammaPrint® refines risk stratification in early oestrogen receptor-positive, HER2-negative breast cancer, evolving from a binary to a four-tier classification (UltraLow-Risk, Low-Risk, High-Risk 1, and High-Risk 2). The relationship between routine histopathological features, immune infiltration, and genomic risk within this framework remains incompletely characterized in luminal disease. We retrospectively analysed 492 luminal breast carcinomas with available MammaPrint® results. Clinicopathological variables (including histological subtype, grade, Ki-67, hormone receptor expression, lymphovascular invasion (LVI), and HER2-low status) were recorded. Stromal tumour-infiltrating lymphocytes (TILs) were quantified according to the criteria of Salgado et al. and spatially categorized as immune-deserted, stromal-restricted, immune-excluded, or inflamed patterns. CD4 and CD8 infiltration was assessed by immunohistochemistry on tissue microarrays. Associations with binary and four-tier MammaPrint® categories were examined using multivariable models. High-Risk tumours (41%) were enriched for increased grade, Ki-67, and LVI and lower PR expression. In High-Risk tumours, inflamed spatial patterns were more frequent and median TIL levels were significantly higher compared with Low-Risk tumours (15% vs 5%, P < 0.001). CD4 and CD8 infiltration increased with genomic risk, and CD4 retained a modest but statistically significant association after adjustment for conventional pathological variables. In the four-tier model, UltraLow-Risk/Low-Risk tumours showed minimal TILs and were enriched for invasive lobular carcinoma, whereas High-Risk 1/High-Risk 2 tumours displayed progressively higher proliferative and immune features. No association was observed between HER2-low status and genomic risk. Immune infiltration parallels proliferative and genomic risk gradients in luminal breast cancer. These findings indicate that immune descriptors align with the genomic risk continuum, although their independent prognostic contribution beyond established genomic assays requires further evaluation.

Humans↗

PubMed1988

Refined chromosome study helps define prognostic subgroups in most patients with primary myelodysplastic syndrome and acute myelogenous leukaemia.

Based on a 6 1/2-year study of 284 consecutive adult patients with primary myelodysplastic syndrome (MDS) and and acute myelogenous leukaemia (AML), we have found that refined chromosome analysis can be used as an independent prognostic indicator in the great majority of patients with MDS and AML. In MDS, the FAB subtype was also found to have prognostic value and this was enhanced when the chromosomal findings were taken into consideration. In AML, the age of the patient correlated more closely with the chromosomal changes in predicting prognosis in most patients than did the FAB classification. Previously we reported that refined chromosome analysis of bone marrow specimens from 161 adult patients with primary or non-therapy related MDS and AML identified three prognostic chromosomal categories in each disease, representing 40% of all patients (Yunis et al, 1984, 1986). By extending our study to 284 patients, as well as a longer follow-up, it was possible to determine the prognostic implications of two additional chromosomal categories in MDS and five in AML. Since 73% of all patients are now represented in well-defined chromosomal subgroups with prognostic significance, refined chromosome analysis emerges as a tool that could have considerable impact in protocols.

Adolescent↗

PubMed1991

Immunological classification of childhood acute lymphoblastic leukemia.

Seven hundred and forty-four newly diagnosed patients with acute leukemias between 1978 and 1990 were classified on the basis of immunological phenotypes. The majority of the patients were enrolled in the Tokyo Children's Cancer Study Group (TCCSG) studies. The incidence of subclassification of acute leukemias in this study was as follows: 522 patients with ALL (70%), 139 patients with ANLL (18%), 29 patients with biphenotypic leukemia, 8 patients with Ph1-positive acute leukemia (Ph1-AL), and 45 patients with infant leukemia. ALLs were classified into common ALL (cALL, 77%), T-ALL (15%), B-ALL (4%), and unclassified ALL (3%). The incidence of ALL subtypes in this study reflected those of TCCSG. Biphenotypic leukemias were categorized into 4 groups as follows; 1) cALL with positive myelomonocytic antigen(s) (N = 11), 2) unclassified ALL with positive myelomonocytic antigen(s) (N = 5), 3) ANLL with positive B-lymphoid antigen(s) (N = 4), and 4) acute leukemia with positive T-lymphoid and myeloid antigen(s). Infant leukemias were classified into ALL type (N = 27) and ANLL type (N = 18). In this present study, clinical features and immunological phenotypes of the acute leukemias with a poor prognosis, i.e. biphenotypic leukemia, Ph1-AL, and infant leukemia are analyzed and discussed.

Adolescent↗

PubMed1995

Immunocytochemical and flow cytometric detection of proteinase 3 (myeloblastin) in normal and leukaemic myeloid cells.

Proteinase 3 (P3) is a serine proteinase present in the primary granules of neutrophils. We have investigated the expression of this protein in samples of bone marrow from healthy individuals and patients with different types of leukaemias by using immunocytochemical staining and flow cytometric quantitation. In normal bone marrow the enzyme was found in promyelocytes, myelocytes, metamyelocytes, band forms and polymorphonuclear neutrophils, correlating with the synthesis of neutrophil serine proteinases during myeloid maturation. No staining was found within the lymphoid, erythroid and megakaryocytic lineage. In the leukaemic samples, only those of acute myeloid and chronic myeloid leukaemia patients were labelled with the antiproteinase 3 antibody. Cases of acute lymphoblastic and chronic lymphocytic leukaemia, as well as other malignant lymphomas, were consistently negative, indicating that P3 may be used as a specific marker for the discrimination between myeloid and lymphoid leukaemias. In addition, immunoreactivity of myeloperoxidase (MPO) was investigated and the expression of P3 and MPO correlated with the French-American-British (FAB) classification. P3 was not detected in minimally differentiated M0 and M1 cases but was in predominantly labelled cells of M2 and M3 subtypes plus half of the M4 and one out of six M5 cases but not those of M6. These findings correspond to the differentiation stage in which P3 is expressed and stored in the primary granules. Therefore the enzyme may also be used as an adjunct to the classic morphological and cytochemical methods to elucidate further the stage at which the differentiation arrest of the leukaemic clone has occurred.

Acute Disease↗

PubMed1995

Dendritic reorganisation in the basal forebrain under degenerative conditions and its defects in Alzheimer's disease. I. Dendritic organisation of the normal human basal forebrain.

In the present study, the dendritic organisation of neurones in the normal human basal forebrain was analysed as a prerequisite for the evaluation of pathological changes occurring in Alzheimer's disease and related conditions (see other Arendt et al. papers in this issue). Neurones in the basal nucleus of Meynert (NbM), the nucleus of the vertical limb of the diagonal band, and the medial septal nucleus were examined after Golgi impregnation. Cells were classified according to the dendritic branching pattern and soma shape as either reticular neurones or multipolar giant neurones. The reticular type of neurones constitutes more than 90% of neurones in the BnM. Cholinergic neurones also belong to this cell type. Reticular neurones were further subdivided into four subtypes. Morphological features and arrangement of reticular basal forebrain neurones were identical to those described for "reticular formation cells" or "isodendritic" neurones. Dendritic trees of reticular neurones show a spatial orientation perpendicular to passing fibres as well as a high degree of overlap, both of which are hallmarks of "open nuclei." The qualitative classification of Golgi-impregnated basal forebrain neurones was substantiated by a computer-based three-dimensional analysis. Topologic and metric parameters of the dendritic tree were calculated for each type of neurone to characterise the degree of dendritic branching, the shape and orientation of the dendritic arborisation, the spatial extension of the dendritic tree, and soma size. The classification criteria were evaluated according to their power of discrimination between different cell types by means of a discriminant analysis. The quantitative approach applied in the present study not only provides an objective measure for the description and comparison of the structure of various types of neurones but also makes it possible to elucidate fine structural changes that might occur under pathologic conditions and that are not evident during qualitative studies alone.

Adult↗

PubMed1991

Leukaemia cases in Central Hospital, Riyadh (Saudi Arabia)

A total of 293 cases of various types of leukaemia admitted in Central Hospital (Riyadh) were studied from January 1981 to December 1988. The incidence of leukaemia was worked out to be 0.13% of the total hospital population during this period. Acute non-lymphocytic leukaemia (ANLL) or acute myeloid leukaemia (AML) group was the most frequent (37.54%), followed by acute lymphocytic leukaemia (24.23%) followed by chronic myeloid leukaemia [corrected] (19.11%), chronic lymphocytic leukaemia (CLL) group (18.77%) and lymphosarcoma cell leukaemia (LSCL) (0.35%). Acute leukaemias were further classified into subtypes on the basis of FAB (French-American-British) classification. In ANLL or AML group, the pattern was M2 greater than M4 greater than M3 greater than M6 greater than M1 greater than M5. In ALL group, the pattern was L2 greater than L1 greater than L3. Among FAB subtypes of acute leukaemias, the pattern was L2 greater than M2 greater than M4 greater than M3 greater than M6 greater than M1 and L1 greater than L3 greater than M5. The age range of these patients was 5 years to 80 years; only 9 cases were less than 11 years of age. In childhood and young adults, acute leukaemias (ALL and AML) were the commonest types (particularly ALL was common in childhood), whereas CML was common in adults and CLL in old age. Males dominated the females in all the types of leukaemia (male to female ratio was 2.4:1). Out of 293 leukaemia cases, 149 (51.0%) were Saudi Arabs, the rest were expatriates. AML was found to be the most common type in central, western and southern Saudi Arabia.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1994

Expression of alpha 1-adrenoceptor subtypes in rat tissues: implications for alpha 1-adrenoceptor classification.

We report here the mapping of the mRNA distribution of three different alpha 1-adrenoceptor subtypes (alpha 1b, alpha 1c and alpha 1d) in various rat tissues. cDNA fragments covering the region from the fifth to seventh putative transmembrane spanning domains of these three alpha 1-adrenoceptor subtypes were generated from rat hippocampus using reverse transcription coupled to polymerase chain reaction (PCR). These three alpha 1-adrenoceptor cloned cDNA fragments were then used as subtype-selective cDNA probes in Northern blot analysis. Of the three specific DNA probes only the rat alpha 1b-adrenoceptor probe hybridized to mRNA of rat liver. The rat alpha 1c-adrenoceptor probe hybridized to a mRNA species of 3.7 kb in tissues that have been reported to contain the classical pharmacologically-defined alpha 1A-adrenoceptor such as hippocampus, vas deferens, lung and salivary gland. Also, a major mRNA transcript of 2.7 kb was detected in hippocampus, vas deferens and lung, using the rat alpha 1d-adrenoceptor probe. In addition, pharmacological characterization of [3H]prazosin binding to three stably transfected mammalian cell-lines expressing one of the three alpha 1-adrenoceptor subtypes cloned to date (namely, alpha 1b--of the hamster smooth muscle DDT1-MF2 cell-line, the bovine brain alpha 1c--and the rat cerebral cortical alpha 1d-adrenoceptors) was performed. Of the three cloned alpha 1-adrenoceptor subtypes that alpha 1c-adrenoceptor showed a similar pharmacological profile to that of the classical alpha 1A-adrenoceptor of rat salivary gland. Our data on the pharmacological profile and expression pattern of the alpha 1c-adrenoceptor indicate, in contrast to earlier claims (Schwinn et al., J. Biol. Chem. 265, 1990), that this subtype is in fact the classical pharmacologically-defined alpha 1A-adrenoceptor subtype.

Amino Acid Sequence↗

PubMed1984

Nuclear morphologic and morphometric analyses of large noncleaved cell and immunoblastic non-Hodgkin's lymphomas.

Both morphologically and immunologically, non-Hodgkin's lymphoma (NHL) of the large cell type has been shown to be a heterogeneous category. However, the homogeneity of the nuclear parameters, particularly size and condensed chromatin organization, used to classify this subtype of NHL has not been investigated. In fact, objective morphologic techniques have not been systematically applied to verify the segregation of NHL on the basis of nuclear parameters, a concept common to all current classification systems. In this study morphometric image analysis was used to compare the nuclei in 20 specimens from NHLs of the large cell type with those in mantle zone and germinal center lymphocytes from lymph nodes with reactive hyperplasia. Results of the assessment of mean nuclear area in large cell lymphomas revealed that this class is also heterogeneous, with some of the specimens having a nuclear size in the upper range of that for normal small lymphocytes. In addition, in only a few of these specimens was the mean nuclear area within the range of that for fully transformed germinal center lymphocytes. The majority of large cell lymphomas have a nuclear size more characteristic of partially transformed lymphocytes in germinal centers. In addition to indicating inconsistencies in the current diagnostic criteria used in NHL classifications, the results indicate reasons for interobserver variations in clinicopathologic trials; the validity of nuclear size as a prognostic indicator and the biologic basis for classifying NHL as a reflection of normal lymphocyte transformation are also questioned. In terms of patient management, the classifications of NHL currently used require objective reappraisal.

Cell Nucleus↗

PubMed1991

Major histocompatibility complex class II genes and systemic sclerosis.

1. In no ethnic group is the overall association between systemic sclerosis and the MHC strong enough for direct clinical use. MHC associations do support the classification of the disease into limited cutaneous systemic sclerosis and diffuse cutaneous systemic sclerosis. 2. Indications are that associations between specific subsets of patients with systemic sclerosis and genetic markers will assume greater importance both diagnostically and prognostically. The group with lung fibrosis look prime candidates, for example. 3. Genetic markers are useful means of relating chemically induced systemic sclerosis like disorders with the classical disease. Vinyl chloride disease provides an example. 4. Evidence is emerging of strong associations between certain genetic markers and autoantibody production; a similar story has emerged in systemic lupus erythematosus. We believe that, eventually, genetic tests will be used to influence treatment in at least a subset of patients with systemic sclerosis but that a dramatic breakthrough will not be made until we know how the genetics of the disease relate to the primary biochemical disease characteristic--that is, the overproduction of collagen. In this respect it has been suggested that the 5' flanking DNA of dermal collagen genes is particularly susceptible to the action of Scl-70 (topoisomerase I). A problem is how to tie this and the other observations discussed above together. The association of autoantibodies with topoisomerase I provides a tentative link between the MHC and collagen gene expression. Although the role and reason for anti-Scl-70 in systemic sclerosis is unknown, humoral autoimmunity, at least in systemic lupus erythematosus, seems to be strongly dependent on specific HLA genes. With an understanding of the function of MHC products at the molecular level, HLA and disease associations can now be analysed on a mechanistic level. For insulin dependent diabetes mellitus it has been shown that the MHC determined susceptibility to the disease is conferred by neutral residues (Val, Ser, Ala), at position 57 of the DQ beta chain, while Asp at this position correlates with resistance. A similar phenomenon has been described in rheumatoid arthritis. Although DR4 in general is associated with rheumatoid arthritis, it is heterogeneous, but a subtype of DR4 which is characterised by positively charged residues at positions 70 and 71 of the beta chains is not found in patients with rheumatoid arthritis (Wordsworth B P et al, unpublished data). A similar approach applied to the study of systemic sclerosis is likely to be similarly rewarding. The precise subtyping of the class II genes and the characterisation of their associated haplotypes is therefore required for a complete understanding of the contribution of the MHC to the disease. Additional genes linked to the MHC must not be overlooked, and are relevant to associations of haplotypes with the disease. Of particular interest are the recent reports of a new class of proteins, which are determined by genes in the MHC and which are considered to play a part in the assembly of the antigen peptide/MHC molecule complex.

Environmental Exposure↗