158: T and B cell markers in acute lymphoblastic leukemia (ALL)

Abstract

Peripheral blood (PB) lymphocytes from 43 children with ALL and cerebrospinal fluid (CF) cells from 6 of them with meningeal involvement were evaluated several times during the course of the disease for lymphocyte markers. The tests performed were PHA-responsiveness (PHAr) in cell culture, E-rosette formation as T-cell marker and presence of membrane immunoglobulins (mIg) as B-cell marker. It appeared that: a) PB PHAr was moderately decreased in remission and strongly reduced at the onset and in relapse; b) no PHAr was observed in CF cells; c) percentage of T-cells in PB was normal in remission and low at the onset and in relapse; d) percentage of T-cells in CF was consistently lower than in PB; e) percentage of B-cells in PB was normal in remission while at the onset in 15/25 children (60%) was very low (in average 5.4%) and in 10/25 (40%) was higher (in average 18.7%); f) virtually no B-cells was ever found in CF. It could be inferred from our data that a high number of “null” cells, devoided of T- and B-cell markers, is founc in PB both at the onset and in relapse and that CF lymphocytes are “null” cells of leukemic origin. In our study higher percentages of mIg bearing cells predicted a worse prognosis in children treated with a standard not very aggressive protocol. In conclusion lymphocyte markers should be always kept into account in the choise of differentiated schedule treatment, since they may help to provide a functional classification and a better knowledge of pathogenesis and prognosis.

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