Cell birth and death in childhood acute lymphoblastic leukaemia: how fast does the neoplastic cell clone expand?

• Published in: British journal of haematology 1997-09, Vol.98 (4), p.999-1001
• Main Authors: Hirt, Andreas, Leibundgut, Kurt, Ridolfi Lüthy, Annette, Von der Weid, Nicolas, Wagner, Hans‐Peter
• Format: Article
• Language: English
• Subjects: ALL; apoptosis; Biological and medical sciences; birth rate; Cell Death; Cell Division; cell growth; Child; children; Clone Cells - pathology; Hematologic and hematopoietic diseases; Humans; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Medical sciences; Precursor B-Cell Lymphoblastic Leukemia-Lymphoma - pathology; Precursor Cell Lymphoblastic Leukemia-Lymphoma - pathology; Time Factors
• ISSN: 0007-1048; 1365-2141
• DOI: 10.1046/j.1365-2141.1997.d01-3571.x

In 23 children with untreated precursor B‐cell acute lymphoblastic leukaemia (ALL), the daily growth rate of the malignant cell clone was calculated. Cell birth expanded the leukaemic cell clone an average 10–11% per day, programmed cell death or apoptosis reduced the leukaemic cell mass by some 4% per day. From these two variables a net increase in the size of the leukaemic cell population of 6.9 ± 7.3% (range −1.2–27.3%) per day could be calculated. The daily growth rate correlated negatively with the logarithm of the duration of clinical symptoms before the diagnosis of ALL was established (r=−0.680; P = 0.0004). A long history, especially in children with undefined bone pain and arthralgias, was associated with a very slow expansion of the neoplastic cell clone.