Immunological classification of adult lymphocytic leukemia based on the conventional cell markers and monoclonal antibody-defined cell surface antigens
Kawashima, K.; Nagura, E.; Ogura, M.; Murase, T.; Morishita, Y.; Ohno, R.; Kato, Y.; Yokomaku, S.; Mizuno, S.; Takeyama, H.
Nihon Ketsueki Gakkai Zasshi Journal of Japan Haematological Society 48(4): 1017-1029
1985
ISSN/ISBN: 0001-5806 PMID: 3864322 Document Number: 247354
Leukemic blasts from 57 adult patients with acute lymphocytic leukemia (ALL) were tested in each case for the conventional cell markers and monoclonal antibodies-defined surface antigens. By using the conventional cell markers, a clear distinction of 5 subtypes of adult ALL was possible: mature-T ALL (ATL) (E+SmIg-TdT-) in 5 patients; thymic-ALL (E+SmIg-TdT+) in 8 patients; pre-T/pre-B ALL (E-C+SmIg-TdT+) in 7 patients; B-ALL (E-C+SmIg+TdT-) in 2 patients and null-ALL (E-C-SmIg-TdT+/-) in 35 patients. None of the 5 patients with ATL achieved remission, suggesting the worst prognosis among these subtypes. Thymic-ALL represented a close association with mediastinal mass and CNS involvement. The response to treatment of the patients with E+- or C+-ALL was significantly poorer than that of the patients with null-ALL. With the introduction of monoclonal antibodies for defining surface antigens, various T phenotypes were recognized, but were not readily classifiable according to a scheme of normal differentiation proposed. The lymphoblasts not expressing conventional cell markers reacted with either 1 or 2 of OKTs, OKIal, B1 and J-5 in 22 out of 24 patients studied. Patients with cALL+Ia+-ALL did not appear to have a better prognosis than those with cALL-Ia+-ALL. It is possible to define subtypes of adult ALL more precisely by multimarker analysis.