Page 418 - Clinical Hematology_ Theory _ Procedures ( PDFDrive )

402 PART 6 ■ Neoplastic Disorders

TABLE 21.16 Immunological Markers in Acute Lymphoblastic Leukemia

Type FAB TdT CALLA CD7 CD19 HLA-DR Slg

Precursor B-cell ALL L1, L2 + 0 0 + + 0

Common ALL L1, L2 + + 0 + + 0

Pre–B-cell ALL L1, L2 + + 0 + + 0

B-cell ALL L3 0 0 * 0 + + +

T-cell ALL L1, L2 + 0 * + 0 0 0

Null cell ALL L1, L2 + 0 0 0 + 0

* Some cases are positive.

TdT, terminal deoxynucleotidyl transferase; FAB, French-American-British Cooperative Group Classi cation; CALLA, common ALL antigen; CD, cluster designa-

tion; Slg, surface immunoglobulin; +, positive; 0, negative.

CD CD B- x m . T - m

ALL x m. m x m % %.

I ALL m AML,

m m k.

I ALL m x PROGNOSIS OF ALL

m m k . M

, , , - T m m ALL

, l - , m , m x . m . F

U k AML, m ALL

k m m m ( . ).

m CNS. C m I , % ,

k m % . A % %

CNS. ALL m , %

P m ALL : % m x m m .

m - m ALL

m m - m .

- k m m ,

m . T m NOTE: This is a good time to complete Review Questions

-m k - related to the preceding content.

m x . M m

TABLE 21.17 Prognostic Factors in Pediatric ALL

Favorable Factor Adverse Factor

Age 1 to <10 y <1 y or ±10 y

Gender Female Male

Race or ethnic group White, Asian Black, Hispanic, Native American

Initial WBC count <50.0 × 10 /L Equal or >50.0 × 10 /L
9
9
Immunophenotype B-cell lineage T-cell lineage

Cytogenic features ETV 6-RUNX1, hyperdiploidy, favorable BCR-ABL1, MLL rearrangements, hypodiploidy

chromosome trisomies

Genomic features ERG deletions IKZF1 deletion or mutations, Philadelphia

chromosome–like ALL with kinase gene alterations

Modi ed from Hunger SP, Mullighan CG. Acute lymphoblastic leukemia in children, N Engl J Med, 373(16), 1541–1552, 2015.