RESUMEN
Our laboratory has been involved in the study of glutathione-sulfhydryl-transferase-pi (GST-pi) for several years. We have recently observed that during haematopoiesis in BMSC liquid cultures from CML patients who were candidates for transplant GST-pi was expressed in presumably malignant cells during different stages of cellular maturation. To confirm this finding, in the present work we are detecting GST-pi expression by immunofluorescence in BCR-ABL+ and BCR-ABL- cells done by FISH of PB from 30 CML patients during different clinical status: treatment (T), hematological relapse (R), blastic crisis (BC) or post-allotrasplant (PT). As well as in PB from 30 Blood-Bank donors. The results were %BCR-ABL+ GST-pi+ cells: T = 1-67, R = 33-69, BC = 90-100 and PT = 1-2; %BCR-ABL- GST-pi+ cells: T = 2-31, R = 5-18, BC = 0-10 and PT = 2-5; %BCR-ABL- GST-pi- cells: T = 2-97, R = 13-62, BC = 0 and PT = 93-96; %BCR-ABL+ GST-pi- cells: T = 0, R = 0, BC = 0 and PT = 0. GST-pi was not expressed in donor cells. The results obtained confirm our previous observations and suggest that GST-pi expression might be used for the evaluation of the minimal residual disease in CML patients.
Asunto(s)
Proteínas de Fusión bcr-abl/biosíntesis , Proteínas de Fusión bcr-abl/genética , Glutatión Transferasa/biosíntesis , Glutatión Transferasa/genética , Isoenzimas/biosíntesis , Isoenzimas/genética , Leucemia Mielógena Crónica BCR-ABL Positiva/genética , Leucemia Mielógena Crónica BCR-ABL Positiva/patología , Adolescente , Adulto , Anciano , Células Cultivadas , Femenino , Regulación Leucémica de la Expresión Génica , Gutatión-S-Transferasa pi , Humanos , Masculino , Persona de Mediana EdadRESUMEN
We studied the response to treatment and survival of 30 adults with acute lymphocytic leukemia (ALL) and 19 with acute non lymphoid leukemia (ANLL) classified on basis of immunophenotype (monoclonal antibodies) and cytochemistry. For the ALL cases 70% corresponded to common ALL (CALLA positive), 23% to B lymphocytes and 7% to T cells. We had 68% of the ANLL patients classified as myeloid, 21% as hybrid (positive both myeloid and lymphoid markers) and 11% as undifferentiated. We analyzed demographic data (gender and age), basic laboratory values (hemoglobin, leucocytes, platelets and cytomorphology in peripheral blood and bone marrow) using the French-American-British classification, and found no statistically significant differences between ALL and ANLL. Three of four patients (75%) with hybrid ANLL achieved complete remission (CR), while 46% of cases with myeloid ANLL and none of the subjects with undifferentiated ANLL reached CR; these differences were not statistically significant. Patients with common ALL had a median survival (SV) of 499 days, for B cell ALL it was of 212 days, and for T cell ALL of 285 days. Our data suggest that: a) expression of lymphoid markers in patients with ANLL is probably associated with a higher CR ratio, and b) SV in adults with common ALL seems to be longer than in those with B and T cell ALL.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Leucemia Mieloide Aguda/tratamiento farmacológico , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamiento farmacológico , Adolescente , Adulto , Femenino , Histocitoquímica , Humanos , Inmunofenotipificación , Leucemia Mieloide Aguda/clasificación , Leucemia Mieloide Aguda/mortalidad , Masculino , Persona de Mediana Edad , Leucemia-Linfoma Linfoblástico de Células Precursoras/clasificación , Leucemia-Linfoma Linfoblástico de Células Precursoras/mortalidad , Tasa de SupervivenciaRESUMEN
This study describes the cytogenetic alterations in patients with chronic myelogenous leukemia (CML) seen at the Instituto Nacional de Cancerologia (INCAN), Mexico City, whether they have been treated previously or not. It correlates these findings with the prognosis. We studied 31 patients seen during June 1987 and June 1990. Philadelphia (Ph+) chromosome was present in 61% of all specimens. In 10 cases it was the only anomaly, resulting in a survival greater than 40 months. Aneuploidies were seen in 50% of patients with previous treatment and in 31.5% of those without treatment. Patients with numerous abnormalities and double Ph+ (with or without Ph+ chromosome) had a mean survival of 32 months. The worst prognosis was seen in the a cases with no growth, with a mean survival of 19 months. This study suggests that the prognosis of patients with CML correlates with the cytogenetic anomalies whether patients have been treated previously or not. It also seems that the group of patients whose cytogenetic study does not grow or cannot be evaluated upon direct exam have a worse prognosis which may be secondary to intrinsic defects of the neoplastic cells that do not grow in vitro, resulting in a more aggressive disease in vivo.