Acute Leukemias - Republican Scientific Medical Library

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130 Chapter 8 · Diagnosis of Acute Lymphoblastic Leukemia A report from the Children’s Cancer Group. J Clin Oncol 16: 527– 535 77. Wagner VM, Baehner RL (1977) Lack of correlation between blast cell size and length of first remission in acute lymphocytic leukemia in childhood. Med Pediatr Oncol 3:373–377 78. Walters R, Kantarjian HM, Keating MJ, Estey EH, Trujillo J, Cork A, McCredie KB, Freireich EJ (1990) The importance of cytogenetic studies in adult acute lymphocytic leukemia. Am J Med 89: 579–587 79. Weinkauff R, Estey EH, Starostik P, Hayes K, Huh YO, Hirsch- Ginsberg C, Andreeff M, Keating M, Kantarjian HM, Freireich EJ, et al. (1999) Use of peripheral blood blasts vs bone marrow blasts for diagnosis of acute leukemia. Am J Clin Pathol 111: 733–740 80. WHO (2000) In: Jaffe ES, Harris NL, Stein H, Vardiman JW (eds) World Health Organization classification of tumours. Pathology and genetics of tumours of haematopoietic and lymphoid tissues. IARC Press, Lyon, pp 111–187 81. Wibowo A, Pankowsky D, Mikhael A, Wright T, Steele PE, Schumacher H (1996) Adult acute leukemia: Hand mirror cell variant. Hematopathol Mol Hematol 10:85–98 82. Wright S, Chucrallah A, Chong YY, Kantarjian H, Keating M, Albitar M (1996) Acute lymphoblastic leukemia with myeloperoxidase activity. Am J Hematol 51:147–151 83. Wynn TT, Heerema NA, Hammond S, Ranalli M, Kahwash SB (2003) Acute lymphoblastic leukemia with hypereosinophilia: Report of a case with 5q deletion and review of the literature. Pediatr Dev Pathol 6:558–563 84. Xia Y, Brown L, Yang CY, Tsan JT, Siciliano MJ, Espinosa R III, Le Beau MM, Baer RJ (1991) TAL2, a helix-loop-helix gene activated by the (7;9)(q34;q32) translocation in human T-cell leukemia. Proc Natl Acad Sci 88:11416–11420
Acute Lymphoblastic Leukemia: Clinical Presentation, Diagnosis, and Classification Richard A. Larson, John Anastasi Contents 7.1 Introduction .................... 109 7.2 Clinical Presentation .............. 109 7.2.1 Epidemiology ................ 109 7.2.2 Presentation ................. 110 7.3 Diagnosis ...................... 110 7.3.1 Initial Laboratory Evaluation ...... 110 7.3.2 Cytomorphology .............. 110 7.3.3 Histology ................... 111 7.3.4 Phenotype .................. 113 7.3.5 Cytogenetic Evaluation ......... 116 7.3.6 Molecular Evaluation ........... 116 7.4 Conclusion ..................... 116 References ......................... 116 7.1 Introduction Acute lymphoblastic leukemia (ALL) is a malignant neoplasm of lymphocytes characterized by the clonal accumulation of immature blood cells in the bone marrow. These abnormal cells are arrested in the lymphoblast stage of the normal maturation pathway. Aberrations in proliferation and differentiation of these cells are common, and normal hematopoiesis is suppressed. Symptoms result from varying degrees of anemia, neutropenia, and thrombocytopenia or from infiltration of ALL cells into tissues. Although virtually any organ system may become involved, once leukemia cells enter the peripheral blood, the lymph nodes, spleen, liver, central nervous system (CNS), and skin are the most common sites detected clinically. ALL is a heterogeneous disease with distinct biologic and prognostic groupings. Treatment strategies tailored to specific prognostic groups have already yielded dramatic improvements in the outcomes for children with ALL, and similar risk-adapted strategies based on the biological heterogeneity of the disease are now being applied to adults with ALL. Increasing knowledge of the cytogenetic classification of this disease plays an important role in the prognostic groupings, and thus, cytogenetics will be emphasized in this review. 7.2 Clinical Presentation 7.2.1 Epidemiology ALL is the most common malignant disease in childhood, peaking in incidence between ages 2 to 5. In contrast, ALL only accounts for approximately 20% of acute leukemias in adults. Although the median age for adults with ALL who are entered onto clinical trials is 30–35 years, it is very likely that older patients are underrepresented in these reports. Registry data suggest that the incidence of ALL increases steadily above the age of 50 years [1]. The incidence of ALL is more common in Caucasians compared with African-Americans; the age-adjusted overall incidence in the USA is 1.5/100 000 in whites and 0.8/100 000 in blacks [1, 2]. Geographic variations, with higher incidence rates in Spain and among Latin Americans, are likely related to a number of factors including socioeconomics, ethnicity, and an urban or rural setting [3]. A higher frequency of ALL has been reported in industrialized countries and urban areas.
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E.H. Estey · S.H. Faderl · H. M.
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E. H. Estey Department of Leukemia
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VI Table of Contents 14 Philadelphi
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VIII Contributors S. H. Faderl Depa
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X Contributors D. Wartenberg Depart
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Therapy of AML Elihu Estey Contents
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a 1.2 · Standard Therapy 3 Table 1
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a 1.2 · Standard Therapy 5 Table 1
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a 1.2 · Standard Therapy 7 tween G
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a 1.2 · Standard Therapy 9 Fig. 1.
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a 1.2 · Standard Therapy 11 of tre
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a 1.2 · Standard Therapy 13 Table
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a 1.2 · Standard Therapy 15 permit
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a References 17 19. Care RS, Valk P
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a References 19 6-thioguanine in th
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Acute Myeloid Leukemia: Epidemiolog
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a 3.1 · Epidemiology 49 3.1.4 Gend
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a 3.2 · Etiology 51 part of the in
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a 3.2 · Etiology 53 for the develo
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a References 55 38. Crane MM, Stom
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Relapsed and Refractory Acute Myelo
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a 4.2 · Prognostic Factors in Pati
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a 4.3 · Treatment of Relapsed and
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a 4.4 · Hematopoietic Stem Cell Tr
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a 4.6 · Gemtuzumab Ozogamicin 65 T
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a 4.7 · Relapsed and Refractory Ac
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Page 79 and 80: Molecular Biology and Genetics Meir
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Page 93 and 94: Diagnosis of Acute Lymphoblastic Le
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a 13.5 · Prognostic Factors 173 13
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a References 175 Only patients with
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Philadelphia Chromosome-Positive Ac
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a 14.2 · Molecular Biology of the
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a 14.3 · Treatment of Ph+ ALL 181
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a 14.4 · Hematopoietic Stem Cell T
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a References 185 2. Kurzrock R, Sht
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a References 187 56. Mori T, Manabe
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a References 189 acute lymphoblasti
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192 Chapter 15 · Burkitt’s Acute
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204 Chapter 16 · Treatment of Lymp
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216 Chapter 17 · The Role of Allog
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230 Chapter 18 · The Role of Autol
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238 Chapter 19 · Novel Therapies i
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248 Chapter 20 · Minimal Residual
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264 Chapter 21 · Central Nervous S
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276 Chapter 22 · Relapsed Acute Ly
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278 Chapter 22 · Relapsed Acute Ly
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Emergencies in Acute Lymphoblastic
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a 23.5 · Hyperleukocytosis 283 LA
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a 23.9 · Neurological Complication
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a References 287 29. Hingorani AD,
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Subject Index A aberrant methylatio
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a Subject Index 291 CREB, see enhan
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a Subject Index 293 MUD, see matche
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