• Vol. 43 No. 3, 152–159
  • 15 March 2014

Immunophenotypic, Cytogenetic and Clinical Features in Chinese Adult Acute Lymphoblastic Leukaemia (ALL) Patients



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Introduction: This study sought to investigate the immunophenotypic subtype profiles of 110 Chinese adult patients with acute lymphoblastic leukaemia (ALL) and its association to cytogenetics and the clinical features.

Materials and Methods: A total of 110 adult patients with ALL were immunophenotyped by CD45/SSC double parameters and 4 colour flow cytometry. Seventy-three cases were also subjected to karyotype analysis by R-banding technology. The clinical and laboratory data of 110 ALL patients were retrospectively analysed.

Results: Of all the patients, 21.8% were identified as T-ALL, 78.2% as B-ALL. Abnormal karyotypes were detected in 37 out of 73 (50.7%) cases and the most common cytogenetic abnormality was the Philadelphia (Ph) chromosome, which was found in 23.3% (17/73) of the cases. Myeloid antigen (MyAg) expression was documented in 47.3% of the 110 adult ALL cases analysed and CD13 was the most commonly expressed MyAg in ALL patients (32.1 %). No difference was observed in the expression of MyAg between the groups of patients with T-ALL (45.8%) and B-ALL (47.7%). Our data showed that older age, higher CD34 positivity and lower proportion of patients with splenomegaly were found to be correlated with MyAg+ ALL, and that patients with Ph+ B-ALL were older, presented with higher haemoglobin level and higher CD34 expression. No statistical difference was noted in complete remission (CR) rate, relapse rate, induction mortality or total death rate among My+ and My-, Ph+ and Ph-, or B-ALL and T-ALL patients.

Conclusion: Our results indicate that the distribution of ALL in Chinese adult patients was similar with the general distribution pattern in the other countries, and the expression of MyAg in patients with T-ALL and B-ALL was comparable. Both the expression of MyAg and the presence of Ph chromosome in adult ALL were significantly associated with median age and CD34 expression while not with the response to induction treatment.

Acute lymphoblastic leukaemia (ALL) is a malignant disease resulting from the accumulation of genetic alterations of B or T lymphoid precursor cells. Immunophenotyping, cytogenetic-molecular studies, and more recently, high resolution genome-wide screening are characterising ALL as a heterogeneous disease with distinct manifestations and prognostic and therapeutic implications. Of the many variables that influence prognosis, genetic subsets, initial white blood cell count (WBC), age at diagnosis, and early treatment response are the most important. ALL is the most common leukaemia in children and accounts for 20% of acute leukaemias in adults, and it remains one of the most challenging adult malignancies, especially with respect to therapy. The 5-year event-free survival is over 80% for children but only approximately 40% for adults with ALL. Though the outcome of patients with ALL has improved with intensification of therapy and complete remission (CR) can now be achieved in majority of adults with ALL, only 30% to 40% of them are cured with varying proportion according to clinical and biological risk factors.

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