Analysis of the Immunophenotype of de novo Acute Lymphoblastic Leukaemia (ALL) in children and adolescents of the Indian subcontinent in relation to clinical symptoms and laboratory tests preceding its diagnosis

Devarajan Sriraman, Anita Chandra, KR Rajalekshmy, Sagar G. Tenali

Research output: Contribution to conferencePoster

Abstract

Background: Studies from various countries have found an increasing incidence of childhood leukemia in
recent decades. However, only a few examples exist in developing Asian countries of the value of determining
the immunologic characteristics of patients with ALL.
Patients and Methods: In the period between January 1990 and December 2002, 395 Indian children and
adolescents (aged 0-25 years) were studied in a prospective way and data analyzed from the Cancer Institute
(WIA ). The aim of the study was to the compare the clinical picture and results of laboratory tests according to
the ALL immunophenotype. Observation was carried out on 321 patients treated in the Department of Medical Oncology. Uniform treatment was given to all patients (except mature B cell type). Immmunophenotypes
were analysed by fl ow cytometry. Conventional immunological markers were used, either associated with or
specifi c for B and T lineage.
Results: Five major immunologic subtypes were disclosed, showing a series of specifi c surface markers: T-cell,
42.7%; ‘common’, 31.5%; Pre-B, 7.8%; Precursor-B, 6.5%; B-cell, 1.9%. T-cell phenotype (42.7%) was the most
frequently encountered followed by Common («CALLA-positive») ALL (31.5%). Other interesting fi ndings, currently of uncertain signifi cance, include the sizeable proportions of pre-B-ALL (group V) and cortical thymocytic ALL (stage III). Although there was only slight predominance of male sex, the prevalence of B and T-ALL
in males was not confi rmed. Haemorrhagic diathesis. splenomegaly, mediastinal mass, enlargement of peripheral lymph nodes as well as higher values of white blood cell count, blast count, haemoglobin concentration,
haematocrit and LDH activity were observed more frequently in patients with T-cell leukaemia. Multivariate
analysis of these subtypes was not statistically signifi cant.
Conclusion: Despite many years of meticulous immunophenotyping of childhood acute lymphoblastic leukaemia (ALL) cases, the prognostic signifi cance of some subtypes remains unclear. These results show that the
incidence of the different immunologic subtypes of lymphoblastic leukaemias and their distribution according to age and sex are not similar to those reported among Caucasians. The results of this study should help
strengthen the emerging leukaemia database in India and thereby contribute to a successful global attack
against the haematological malignancies.
Original languageEnglish
Publication statusPublished - 2005
EventInternational Network on Cancer Treatment and Research: Annual Meeting - CHENNAI, CHENNAI, India
Duration: 10 Dec 200513 Dec 2005

Conference

ConferenceInternational Network on Cancer Treatment and Research
Abbreviated titleINCTR
CountryIndia
CityCHENNAI
Period10/12/0513/12/05

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