Evidence for Clonal Development of Childhood Acute Lymphoblastic Leukemia

To determine whether acute lymphoblastic leukemia (ALL) is a clonal disease and to define the pattern of differentiation shown by the involved progenitor cells, we studied the glucose-6-phosphate dehydrogenase (G6PD) types in the cells of 19 girls heterozygous for this X chromosome-linked enzyme. Ly...

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Bibliographic Details
Published in:Blood 1985-10, Vol.66 (4), p.902-907
Main Authors: Dow, Lois W., Martin, Paul, Moohr, John, Greenberg, Michael, Macdougall, Lorna G., Najfeld, Vesna, Fialkow, Philip J.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Antibodies, Monoclonal
Biological and medical sciences
Blood Cell Count
Blood Cells - enzymology
Child
Child, Preschool
Clone Cells
Female
Flow Cytometry
Glucosephosphate Dehydrogenase - blood
Glucosephosphate Dehydrogenase - genetics
Hematologic and hematopoietic diseases
Humans
Leukemia, Lymphoid - blood
Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis
Male
Medical sciences
Neoplastic Stem Cells - physiopathology
Skin - enzymology
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Summary:To determine whether acute lymphoblastic leukemia (ALL) is a clonal disease and to define the pattern of differentiation shown by the involved progenitor cells, we studied the glucose-6-phosphate dehydrogenase (G6PD) types in the cells of 19 girls heterozygous for this X chromosome-linked enzyme. Lymphoblast immunophenotypes were those of HLA-DR+, CALLA+ ALL (six patients); HLA-DR+, CALLA- ALL (four patients); pre-B cell ALL (two patients); T cell ALL (four patients); and undefined ALL (three patients). Malignant blast cells at diagnosis from ten patients displayed a single G6PD type, indicative of clonal disease. In contrast, both A and B G6PD in ratios similar to those found in skin were observed in morphologically normal blood cells from the same patients. The leukemic cells of three patients were examined at both diagnosis and relapse; in each instance the same G6PD type was found, consistent with regrowth of the original leukemic clone at relapse. Results of studies of cells from nine additional patients tested only at relapse were similar. Our results indicate that childhood ALL is a clonally derived disease involving progenitor cells with differentiation expression detected only in the lymphoid lineage. © 1985 by Grune & Stratton, Inc.
ISSN:0006-4971
1528-0020
DOI:10.1182/blood.V66.4.902.902