Abstract
There is both clinical and morphological heterogeneity among adults with Ph chromosome + (Ph'+) leukemia. A sizeable group of these patients respond to vincristine/prednisone (V/P). Experience with 5 Ph' (+) pediatric patients confirms this heterogeneity and suggests that terminal transferase (TdT) may identify V/P responders. Two patients had blastic conversion (myeloblastic morphology) of stable phase CML. One, TdT(+), responded to V/P with an 8-month-remission duration. The second, TdT(-), had no response to V/P. Two other patients presented as de novo ALL. One, TdT(+), responded to V/P with loss of Ph' + in remission. The second, not initially tested for TdT, had 2 years' continuous remission on standard ALL therapy (with persistence of Ph'(+)) and then converted to stable phase CML. Blast crisis (myeloblastic) one year later, was Ph'(+) and TdT(+); there was transient improvement with V/P. The last patient was morphologically undifferentiated, TdT(+) and responded to V/P and daunomycin with loss of Ph (+).
The response of the 4 TdT(+) patients to V/P suggests that such patients, regardless of morphology, may respond to ALL chemotherapy.
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Fosburg, M., Padre-Mendoza, T., Smith, P. et al. TERMINAL TRANSFERASE AND VINCRISTINE-PREDNISONE RESPONSIVENESS IN Ph CHROMOSOME (+) LEUKEMIAS. Pediatr Res 11, 471 (1977). https://doi.org/10.1203/00006450-197704000-00607
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DOI: https://doi.org/10.1203/00006450-197704000-00607
