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Acute Lymphoblastic Leukaemia in Infancy: Clinical and Biological Features.
Leukemia & Lymphoma
|July 27, 2016
Summary
Infant acute lymphoblastic leukemia (ALL) cases show a poor prognosis, with most relapsing rapidly. The t(11;19) translocation subgroup exhibited the worst outcomes, highlighting a critical need for improved infant ALL treatments.
Area of Science:
- Pediatric Oncology
- Hematology
- Genetics
Background:
- Infant acute lymphoblastic leukemia (ALL) is a rare and aggressive form of childhood cancer.
- Understanding the clinical and biological features of infant ALL is crucial for improving treatment strategies and patient outcomes.
Purpose of the Study:
- To present the clinical and biological characteristics of nineteen unselected infant ALL cases.
- To investigate the cytogenetic and immunophenotypic profiles of infant ALL.
- To evaluate the prognostic implications of specific genetic abnormalities, particularly the t(11;19) translocation.
Main Methods:
- Clinical data collection for nineteen infants diagnosed with ALL.
- Karyotyping to identify chromosomal abnormalities in 17 cases.
- Immunophenotyping using flow cytometry to determine cell surface markers (CD10, CD19, HLA DR, CD13, CD33).
- Analysis of immunoglobulin heavy chain (IgH) and T cell receptor (TcR) gene rearrangements.
Main Results:
- Sixteen out of 17 successfully karyotyped cases (94%) showed a translocation of chromosome 11 involving band q23 (t(11;19)).
- The majority of cases were B precursor ALL, with some showing mixed B cell and myeloid markers.
- All cases exhibited IgH gene rearrangement, indicating B lineage, with no T cell receptor gene rearrangements.
- Prognosis was uniformly poor, with rapid bone marrow relapse in most patients within six months.
- Infants with the t(11;19) translocation presented with the worst prognostic features, including high white blood cell counts, organomegaly, and central nervous system disease.
Conclusions:
- Infant ALL, particularly with the t(11;19) translocation, is associated with a very poor prognosis and rapid relapse.
- The consistent presence of t(11;19) and IgH rearrangement in infant ALL supports its distinct biological characteristics.
- Further research and novel therapeutic approaches are urgently needed to improve outcomes for infants diagnosed with ALL.
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