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Reply to van Wering et al

Leukemia volume 15, page 1302 (2001)Cite this article

van Wering et al have used their extensive experience in immunophenotypic analysis of follow-up bone marrow samples from children with ALL to raise two issues discussed in our recent manuscript describing multifluorescent TCRG VG and JG typing at diagnosis:1 first, the percentage of T lymphocytes present in complete remission bone marrow aspirates at the end of induction therapy and second, the capacity of fluorescent gene scan analysis without junction specific probes to reproducibly achieve a 5 × 10−3 level of sensitivity of detection.

With regard to the proportion of T lymphocytes in early complete remission bone marrow, this is obviously determined by the extent of dilution by peripheral blood, which is, in turn, determined by the volume of marrow aspirated. While we accept that hemodilution is more likely in early remission samples, we are surprised at the mean 38% CD3 positivity described by van Wering, albeit analyzed on a gated population. Morphological assessment of approximately day 35 bone marrow samples from 32 children treated on the French FRALLE93 protocol showed a median lymphocyte count of 9.5%, mean 14%, range 0–67%. This difference is unlikely to be protocol-based since both are BFM-based, and is more likely to result from the different analytical procedures and/or the extent of hemodilution. As a measure of the latter, we have compared the proportion of erythroblasts and lymphocytes. Morphologically, erythroid cells represented on average 42% (median 37%; range 3–72%) of nucleated cells, in keeping with relatively limited hemodilution. It would be interesting to compare these data with the immunophenotypic estimate of the proportion of erythroid precursors in the Ficolled fractions analyzed by van Wering et al.

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Authors and Affiliations

  1. Department of Hematology, Tour Pasteur, Hôpital Necker-Enfants Malades, Paris, France

    E Delabesse, K Beldjord, C Millien & E Macintyre

  2. Hôpital St Louis, Paris, France

    J-M Cayuela

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  1. E Delabesse
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  2. K Beldjord
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  3. J-M Cayuela
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Delabesse, E., Beldjord, K., Cayuela, JM. et al. Reply to van Wering et al. Leukemia 15, 1302 (2001). https://doi.org/10.1038/sj.leu.2402185

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