Download Mona Al Harbi

Clinical characteristics and
treatment outcome of Acute
lymphoblastic leukemia with the
t(4;11)(q21;q23):A collaborative
study of 40 cases.
By Ching-Hon Pui, Lawrence S. Frankel, Andrew J. Carroll,
Susana C. Raimondi, Jonathan J. Shuster, David R. Head,
William M. Crist, Vita J. Land, D. Jeanette Pullen, C. Philip
Steuber, Frederick G. Behm, and Michael J. Borowitz
1991.Blood; 77(3):440-447
Introduction
The leukemias are agroup of disorders characterized
by accumulation of malignant WBC in bone
marrow and cells.
The leukemia can classificate depend on how quickly
the disease developes and get wores.
Acute
Lymphoblastic
Chronic
myeloid
lymphoblastic
myeloid
Acute lymphoblastic leukemia(ALL)
_It is rapid form of leukemia of the WBC
characterized by exess unusually immature
destined to become lymphocytes.
ALL result from somatic mutation in DNA which
activation of oncogen and inactivation of tumor
suppressor gene .
_There are deferent kinds of mutation happen in the
DNA (DELETION,TRANSLOCATION,INVERSION).
The mutation which occure in ALL is translocation.
-specific chromosomal translocation convy important biologic
and prognostic information in childhood leukemia , most of
the cases have not undergone complet immunophenotypic
characterization , thus the frequency of this chromosomal
abnormality in childhood leukemia remain unclear.
-t(4;11) strong associated with infant and the prognostic
significance of this t. in other age group is unclear.
The aim of the work
-Describe the frequency clinical and laboratory
features and treatment outcome for 40
children with ALL.
By immunophenotype and chromosomal
analysis.
Material and Methds
Subjects
_The sample is leukemia cell from bone marrow
from total of 1.986 patient.
_1.986 patient successfully karyotyped cases
represent 73% of all children(2.729).
1.986 patient
40 patient(20%)
{25 girls and 15 boys}
515 admitted to total
Therapy at SJCRH
between1979-1989
1.471 enrolledin
POG
Methods
(A) Morphology
(B) Chromosomal analysisi
(C) Immunophenotype
(D) Statistic analysis
(A)Morphology
(B)Chromosomal analysis
(1)Prepare the sample for karyotype
Culture leukemia cell
Metaphase arrest
(2)Staining the slid with G-stain
In karyotype
(C)Immunophenotype
-Get leukocytes by Ficoll-Hypaque
Gradient.
-using flow cytometey
(D)Statistic analysis
Result
Discussion
-In other studies CD24, B-lineage marker present in more
than 95%of cases of B-pre-cell ALL, but in their studies
CD24 was expressed in only B of 28 cases tested
In other studies CD45 present in less than 5% of cases of
B-pre-cell ALL, but in their studies CD45 expression was
found in 20 of their 32 t(4;11)cases .
Conclusion
-Cases with the t(4;11)are associated with
femal sex,very young age at
presentation,hyperleukocytosis,the CD10/CD15+/CD19+/CD24-+
Immunophenotype, and poor treatment
outcome for infants and patient aged
>10years.
Additional studies are clearly merited to
determaine the independent prognostic
significance of the t(4;11)and to assess
possible molecular differences in this t. for
different age groups.