Prognostic significance of peanut agglutinin binding in childhood acute lymphoblastic leukemia
| Autor: | Gj, Kaspers, Anjo JP Veerman, Er, Wering, Be, Linden-Schrever, Ch, Zantwijk, Van Der Does-Van Den Berg A, Pieters R |
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| Předmět: |
Male
Adolescent Antineoplastic Agents Hormonal Arachis Prednisolone Dexamethasone Immunophenotyping Peanut Agglutinin Bone Marrow Predictive Value of Tests Risk Factors Lectins Antineoplastic Combined Chemotherapy Protocols Tumor Cells Cultured Humans Leukemia-Lymphoma Adult T-Cell Child Injections Spinal Probability Infant Prognosis Methotrexate Drug Resistance Neoplasm Child Preschool Female Plant Lectins |
| Zdroj: | Europe PubMed Central |
| Popis: | We previously reported the favorable prognosis associated with positive peanut agglutinin (PNA) binding in childhood T cell acute lymphoblastic leukemia (ALL), and hypothesized that this may be related to glucocorticoid sensitivity (Veerman et al. Cancer Res 1985, 45: 1890). The purposes of this prospective study involving 202 children with newly diagnosed ALL were to determine the relationship between PNA binding and (1) immunophenotype; (2) in vitro resistance to prednisolone (PRD) and dexamethasone and other drugs; (3) clinical response to a systemic PRD monotherapy (plus one intrathecal injection with methotrexate); and (4) multidrug chemotherapy. PNA positivity was more frequent in T cell ALL (65% of 43 cases) than in pro-B (0% of seven cases), common (17% of 106 cases) and pre-B (16% of 45 cases) ALL (P0.001). PNA binding was not associated with in vitro resistance to PRD or dexamethasone. However, in 38 evaluable T cell ALL patients, nine of 13 PNA-negative cases were clinically poor responders to PRD, while all 25 PNA-positive cases were good responders to PRD clinically (P0.0001). The four clinically poor PRD responders with B cell precursor (BCP)-ALL were also PNA negative. Within T cell ALL, PNA-positive patients had a 3.4-fold (95% Cl, 1.1-10.4, P = 0.03) lower relative risk of any event, than PNA-negative patients. Within BCP-ALL, PNA binding was not of prognostic significance. In conclusion, PNA positivity, especially frequent in T cell ALL, is a marker for a subgroup of childhood ALL patients who are very likely to respond well to systemic PRD 'monotherapy'. In addition, PNA positivity is a favorable prognostic factor in T cell ALL. |
| Databáze: | OpenAIRE |
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