Acute lymphoblastic leukemia following preleukemic syndromes in adults

Research output: Contribution to journalArticle

Susan Escudier, M. Albitar, L. E. Robertson, M. Andreeff, S. Pierce, H. M. Kantarjian

Preleukemic syndromes (PLS) evolve to acute myeloid leukemia (AML) in 15-50% of cases, but rarely transform to acute lymphoblastic leukemia (ALL). AML following preleukemic syndromes has a poor prognosis, but little is reported about the outcome of secondary ALL. From the adult leukemia database at MD Anderson Cancer Center, nine patients with ALL following myelodysplastic syndrome (MDS) (n = 6), smoldering leukemia (n = 1), or cytopenias with dysplastic features (n = 2) were identified. Clinical and laboratory features were abstracted from the database, patient charts, review of the bone marrows and special laboratory studies. The median interval from diagnosis of PLS to ALL was 6 months. Blasts with lymphoid morphology and terminal deoxynucleotidyltransferase (TdT) and periodic acid Schiff (PAS) staining were present in eight of nine cases and four of six cases respectively. T cell and myeloid markers were expressed in the majority of cases, but T cell gene rearrangements were not detected. Only one patient had electron microscopic myeloperoxidase-positive staining. Two patients later transformed to AML. Patients were predominantly male (89%) with a median age of 69 years. The complete remission (CR) rate with ALL-directed chemotherapy (78%) was comparable to that of other adult ALL patients (74%) (n = 327) without excess myelosuppression. Marrow dysplasia persisted in CR in three of seven cases. The median remission duration of 16 months (range 4.5 to 51+ months) and the median overall survival of 21 months (range 1 to 55+ months) were comparable to that of ALL patients overall. ALL following preleukemic syndromes is a distinct syndrome with T cell and myeloid markers and responds well to ALL-directed therapy. The presence of myeloid and lymphoid markers suggests the transformation of an early stem cell.

Original languageEnglish (US)
Pages (from-to)473-477
Number of pages5
JournalLeukemia
Volume10
Issue number3
StatePublished - Jan 1 1996

PMID: 8642864

Cite this

Standard

Acute lymphoblastic leukemia following preleukemic syndromes in adults. / Escudier, Susan; Albitar, M.; Robertson, L. E.; Andreeff, M.; Pierce, S.; Kantarjian, H. M.

In: Leukemia, Vol. 10, No. 3, 01.01.1996, p. 473-477.

Research output: Contribution to journalArticle

Harvard

Escudier, S, Albitar, M, Robertson, LE, Andreeff, M, Pierce, S & Kantarjian, HM 1996, 'Acute lymphoblastic leukemia following preleukemic syndromes in adults' Leukemia, vol. 10, no. 3, pp. 473-477.

APA

Escudier, S., Albitar, M., Robertson, L. E., Andreeff, M., Pierce, S., & Kantarjian, H. M. (1996). Acute lymphoblastic leukemia following preleukemic syndromes in adults. Leukemia, 10(3), 473-477.

Vancouver

Escudier S, Albitar M, Robertson LE, Andreeff M, Pierce S, Kantarjian HM. Acute lymphoblastic leukemia following preleukemic syndromes in adults. Leukemia. 1996 Jan 1;10(3):473-477.

Author

Escudier, Susan ; Albitar, M. ; Robertson, L. E. ; Andreeff, M. ; Pierce, S. ; Kantarjian, H. M. / Acute lymphoblastic leukemia following preleukemic syndromes in adults. In: Leukemia. 1996 ; Vol. 10, No. 3. pp. 473-477.

BibTeX

@article{dd41204d6ef64c5da9adb479c946e2d1,
title = "Acute lymphoblastic leukemia following preleukemic syndromes in adults",
abstract = "Preleukemic syndromes (PLS) evolve to acute myeloid leukemia (AML) in 15-50{\%} of cases, but rarely transform to acute lymphoblastic leukemia (ALL). AML following preleukemic syndromes has a poor prognosis, but little is reported about the outcome of secondary ALL. From the adult leukemia database at MD Anderson Cancer Center, nine patients with ALL following myelodysplastic syndrome (MDS) (n = 6), smoldering leukemia (n = 1), or cytopenias with dysplastic features (n = 2) were identified. Clinical and laboratory features were abstracted from the database, patient charts, review of the bone marrows and special laboratory studies. The median interval from diagnosis of PLS to ALL was 6 months. Blasts with lymphoid morphology and terminal deoxynucleotidyltransferase (TdT) and periodic acid Schiff (PAS) staining were present in eight of nine cases and four of six cases respectively. T cell and myeloid markers were expressed in the majority of cases, but T cell gene rearrangements were not detected. Only one patient had electron microscopic myeloperoxidase-positive staining. Two patients later transformed to AML. Patients were predominantly male (89{\%}) with a median age of 69 years. The complete remission (CR) rate with ALL-directed chemotherapy (78{\%}) was comparable to that of other adult ALL patients (74{\%}) (n = 327) without excess myelosuppression. Marrow dysplasia persisted in CR in three of seven cases. The median remission duration of 16 months (range 4.5 to 51+ months) and the median overall survival of 21 months (range 1 to 55+ months) were comparable to that of ALL patients overall. ALL following preleukemic syndromes is a distinct syndrome with T cell and myeloid markers and responds well to ALL-directed therapy. The presence of myeloid and lymphoid markers suggests the transformation of an early stem cell.",
keywords = "Acute lymphoblastic leukemia, Myelodysplastic syndrome, Preleukemic syndrome",
author = "Susan Escudier and M. Albitar and Robertson, {L. E.} and M. Andreeff and S. Pierce and Kantarjian, {H. M.}",
year = "1996",
month = "1",
day = "1",
language = "English (US)",
volume = "10",
pages = "473--477",
journal = "Leukemia",
issn = "0887-6924",
publisher = "Nature Publishing Group",
number = "3",

}

RIS

TY - JOUR

T1 - Acute lymphoblastic leukemia following preleukemic syndromes in adults

AU - Escudier, Susan

AU - Albitar, M.

AU - Robertson, L. E.

AU - Andreeff, M.

AU - Pierce, S.

AU - Kantarjian, H. M.

PY - 1996/1/1

Y1 - 1996/1/1

N2 - Preleukemic syndromes (PLS) evolve to acute myeloid leukemia (AML) in 15-50% of cases, but rarely transform to acute lymphoblastic leukemia (ALL). AML following preleukemic syndromes has a poor prognosis, but little is reported about the outcome of secondary ALL. From the adult leukemia database at MD Anderson Cancer Center, nine patients with ALL following myelodysplastic syndrome (MDS) (n = 6), smoldering leukemia (n = 1), or cytopenias with dysplastic features (n = 2) were identified. Clinical and laboratory features were abstracted from the database, patient charts, review of the bone marrows and special laboratory studies. The median interval from diagnosis of PLS to ALL was 6 months. Blasts with lymphoid morphology and terminal deoxynucleotidyltransferase (TdT) and periodic acid Schiff (PAS) staining were present in eight of nine cases and four of six cases respectively. T cell and myeloid markers were expressed in the majority of cases, but T cell gene rearrangements were not detected. Only one patient had electron microscopic myeloperoxidase-positive staining. Two patients later transformed to AML. Patients were predominantly male (89%) with a median age of 69 years. The complete remission (CR) rate with ALL-directed chemotherapy (78%) was comparable to that of other adult ALL patients (74%) (n = 327) without excess myelosuppression. Marrow dysplasia persisted in CR in three of seven cases. The median remission duration of 16 months (range 4.5 to 51+ months) and the median overall survival of 21 months (range 1 to 55+ months) were comparable to that of ALL patients overall. ALL following preleukemic syndromes is a distinct syndrome with T cell and myeloid markers and responds well to ALL-directed therapy. The presence of myeloid and lymphoid markers suggests the transformation of an early stem cell.

AB - Preleukemic syndromes (PLS) evolve to acute myeloid leukemia (AML) in 15-50% of cases, but rarely transform to acute lymphoblastic leukemia (ALL). AML following preleukemic syndromes has a poor prognosis, but little is reported about the outcome of secondary ALL. From the adult leukemia database at MD Anderson Cancer Center, nine patients with ALL following myelodysplastic syndrome (MDS) (n = 6), smoldering leukemia (n = 1), or cytopenias with dysplastic features (n = 2) were identified. Clinical and laboratory features were abstracted from the database, patient charts, review of the bone marrows and special laboratory studies. The median interval from diagnosis of PLS to ALL was 6 months. Blasts with lymphoid morphology and terminal deoxynucleotidyltransferase (TdT) and periodic acid Schiff (PAS) staining were present in eight of nine cases and four of six cases respectively. T cell and myeloid markers were expressed in the majority of cases, but T cell gene rearrangements were not detected. Only one patient had electron microscopic myeloperoxidase-positive staining. Two patients later transformed to AML. Patients were predominantly male (89%) with a median age of 69 years. The complete remission (CR) rate with ALL-directed chemotherapy (78%) was comparable to that of other adult ALL patients (74%) (n = 327) without excess myelosuppression. Marrow dysplasia persisted in CR in three of seven cases. The median remission duration of 16 months (range 4.5 to 51+ months) and the median overall survival of 21 months (range 1 to 55+ months) were comparable to that of ALL patients overall. ALL following preleukemic syndromes is a distinct syndrome with T cell and myeloid markers and responds well to ALL-directed therapy. The presence of myeloid and lymphoid markers suggests the transformation of an early stem cell.

KW - Acute lymphoblastic leukemia

KW - Myelodysplastic syndrome

KW - Preleukemic syndrome

UR - http://www.scopus.com/inward/record.url?scp=0029993697&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0029993697&partnerID=8YFLogxK

M3 - Article

VL - 10

SP - 473

EP - 477

JO - Leukemia

T2 - Leukemia

JF - Leukemia

SN - 0887-6924

IS - 3

ER -

ID: 3169131