Acute lymphoblastic leukemia in Argentina. Relationship between surface markers and prognosis

Leukemic blasts from patients with acute lymphoblastic leukemia (ALL) were tested initially for the following surface markers: sheep erythrocyte receptors at 4 degrees C and 37 degrees C; receptor for the C3 fraction of complement; mouse erythrocyte receptor; and surface immunoglobulins. We found that 73% of the ALL were devoid of these markers, 9% had C3 receptor only, 2% were B-ALL, and 15% were T-ALL. Only one of 147 cases tested expressed receptors for mouse erythrocyte receptor. C3-ALL predominated in girls and the prognosis was similar to that of the ALL devoid of markers. T-ALL was associated with some high-risk factors, such as high initial leukocyte counts, and a predominance in boys older than 5 years of age. Further studies were done in which cytoplasmic immunoglobulins were evaluated and surface antigens were identified by the following monoclonal antibodies: OKT1, OKT3, OKT4, OKT6, OKT8, OKT9, OKT10, OKT11a, OKIa1, and J5 (anti-CALLA). Less than 1% were B-All, 15% were T-ALL, and approximately 85% were non-T, non-B ALL. Of the latter group, 69% were common-ALL, 16% were pre-B ALL, and 15% were null-ALL. Within the T-ALL, the expression of the T antigenic mosaic was heterogeneous. Results by a multivariate analysis demonstrated that sex, age, initial leukocyte count, and T-cell phenotype were independent variables with a negative prognostic value (p less than 0.01), and the only combination with significant interaction was between T-cell phenotype and leukocyte counts.