Clinical significance of standard CD assessment in acute leukemia.

The data of detailed studies of immunophenotype of blast cells in 426 patients with acute leukemias are presented. Diagnostic and prognostic significance of different marker expression has been evaluated in groups of patients with ALL and AML. Frequency distribution of T1, T2, T3, pre-B, B, common, Ia and null subvariants identified according to immunoclassification of Baryshinkov et al. was studied in 250 children with ALL. These subvariants differed both in duration of disease (p = 0.0015) and in duration of first complete remission (p = 0.0031). The use of monoclonal antibodies of VI-series in 90 patients with ALL allowed to describe an immunophenotype of the subvariants in detail. The mosaic expression of myeloid antigens CD11, CD14, CD15, CDw65 identified by MoAbs VIM-12, VIM-13, VIM-D5 and VIM-2, respectively, on blast cells of patients with AML was shown. The expression of CD11 (ICO-GM1) or CD15 (ICO-G2) was prognostically unfavorable in children with AML (p = 0.0028). The expression of T-cell markers (E-receptor, CD7, reactivity with anti-T-cell serum) on blasts was prognostically favorable in children with AML (p = 0.003). So the data of immunophenotyping are of great value for accurate diagnosis and prognosis of acute leukemias.

[Morphologic and cytochemical characteristics of lymphosarcoma in children with various immunologic subtypes of the disease]. / Morfologicheskaia i tsitokhimicheskaia kharakteristika limfosarkomy u detei pri razlichnykh immunologicheskikh podvariantakh zabolevaniia.

Detailed immunological and cytochemical studies of tumour lymphoblasts in 44 children with lymphosarcoma involved a broad panel of monoclonal antibodies and xenogenic antisera allowed detecting cytomorphological differences between immunological subtypes of the disease. Most homogenic groups represented by T1 and T2 subtypes (L1 type) sharply differed from B-cellular lymphosarcoma (L2, L3, immunoblastic) while T3 and "zero" subtypes were more heterogenic.

[Diagnosis and treatment of large-cell anaplastic lymphoma in children]. / Diagnostika i lechenie krupnokletochnoi anaplasticheskoi limfomy u detei.

Thirty eight children with large-cell anaplastic lymphomas have been recently treated at the Pediatric Department of Malignant Lymphomas, Russian Cancer Research Center, Russian Academy of Medical Sciences. Cytoimmunological studies have revealed that 24 patients had 4 types of cellular elements of large-cell anaplastic lymphoma: Kil(+), Kil(+)B, B-cell, and T-cell lymphomas in 11, 2, 8, and 3 children, respectively. Intensive chemotherapy was performed in relation to the immunophenotype.

[Histiocytosis-related proliferative disorders in children]. / Gistiotsitarnye proliferativnye zabolevaniia u detei.

Differential diagnosis was established by complex morphological examination in 290 pediatric patients with Langerhans cell, sinus or malignant histiocytosis. An immunologic study was performed in one-third of patients. Clinical symptoms and results of therapy are presented.

[Malignant histiocytosis in children]. / Zlokachestvennyi gistiotsitoz u detei.

The analysis of peculiarities of clinical course and morphology of malignant (acute) histiocytosis in 50 pediatric patients made a case for identification of the disease as separate pathology of histiocytic sarcoma type. Clinical course features include: lymphadenopathy, involvement of bones and--less frequently--lungs, skin and subcutaneous fat, marked fever and weight loss. Cytologic and histologic examination show polymorphic tumor cells of varying degree of differentiation, with blasts predominating. Well-developed Golgi complex, presence of lysosomes, phagosomes and erythrophagocytosis are among the characteristic ultrastructural features of the disease.

[Diagnostic criteria and prognosis of mediastinal lesions in children with lymphosarcoma]. / Kriterii diagnostiki i prognoza pri porazhenii sredosteniia u detei, bol'nykh limfosarkomoi.

Treatment for mediastinal lymphosarcoma was given to 71 patients, aged 3-14 years, at the Institute's Clinics during 1982-1991. In that group, there were more males than females (3.4:1), mean duration of the condition of 3 months, T-cell immunity pattern (89.9%), enlarged anterior mediastinal lymph nodes and thymus, pleural lesions including pleuritis, mean mediastinal-thoracic index of 0.5, compression syndrome, elevated concentration of lactate dehydrogenase and presence of tumor cells in the bone marrow and peripheral blood. Among major negative factors of prognosis were inadequate therapy, pleural lesions and stage IV tumor.

[Immunologic prognosis in hemoblastoses in children]. / Immunoprognozirovanie pri gemoblastozakh u detei.

The diagnostic value of monoclonal antibodies is discussed. The expression of ICO-GM1 and ICO-G2 myeloid antigens in pediatric patients with nonlymphoblastic leukemia was associated with poor prognosis whereas patients with the expression of T-cell markers fared better. The prognostic value of the antigens was not altered by brief cytotoxic treatment. The prognosis for non-T-cell ICO-II+ type childhood lymphosarcoma was worse as compared to Ia+ICO-II- lymphoma subset. It was concluded that the biology of malignant cells and degree of cell differentiation (as assessed immunologically) affects treatment outcome significantly and should be considered in individualizing therapy for childhood lymphosarcoma and leukemia.

[Cytokinetic indices and their role in formulating the prognosis and therapy of lymphosarcomas]. / Tsitokineticheskie pokazateli i ikh rol' v formirovanii prognoza i terapii limfosarkom.

The paper presents a retrospective analysis of clinical evidence elucidating correlations between the disease cytomorphology, proliferative activity, clinical stages, hemopoiesis and survival of the patients. A combined approach oriented on individual measurement of the disease proliferative parameters is recommended to increase lymphosarcoma prognosis reliability and administration of adequate therapy.

[Clinical course and prognosis in T-cell lymphoblastic tumors in children typed with Soviet-produced monoclonal antibodies]. / Klinicheskoe techenie i prognoz T-kletochnykh limfoblastnykh opukholei u detei, tipirovannykh otechestvennymi monoklonal'nymi antitelami.

Correlation analysis of the clinical course and prognosis was made in 56 children with T-cell lymphoblastic tumors (acute lymphoblastic leukemia and lymphosarcoma) typed with the use of monoclonal antibodies obtained in this country. The frequency of T-cell marker detection among all immunological subvariants in acute lymphoid leukemia and lymphosarcoma proved to be similar (36.6 and 37%, respectively). In acute lymphoid leukemia type T1 of tumor cells prevailed (58%), while in lymphosarcoma type T3 (63%). T2 and T3-cell lymphoblastic tumors were characterized by the most severe clinical course.

[Role of cytological research methods in the diagnosis of lymphoproliferative diseases in children]. / Rol' tsitologicheskikh metodov issledovaniia v diagnostike limfoproliferativnykh zabolevanii u detei.

Emphasis is laid on the role and high information content of cytological research methods in early diagnosis of oncohematological diseases in children. The Soviet cytoimmunological classification scheme of lymphosarcomas is presented. The use of the scheme will be helpful in unifying the estimation of the tumor substrate in different clinics of this country and will make it possible to carry out cooperative studies. A detailed cytological analysis of differential diagnostic differences in histoproliferative diseases of tumorous and reactive nature is provided. The difficulties of differential diagnosis in cases of bone marrow lesion in neurogenic tumors and acute lymphoblastic leukemia are related. The necessity is stressed of the training of skilled personnel and employing cytologists on the staff of the laboratories of large children's hospitals.

[Differential diagnosis of acute leukemia and hematosarcoma in children]. / O differentsial'noi diagnostike ostrykh leikozov i gematosarkom u detei.

Comparative analysis of hemopoiesis and study of the morphofunctional characteristics of blast cells in 89 children with hematosarcomas and in 152 children afflicted with acute leukemia revealed significant differences both in the nature of blast metaplasia of bone marrow and in the degree of inhibiting erythro- and thrombocytopoiesis in acute leukemias and hematosarcomas in the stage of leukemization. Study of the function of blast cells allowed one to distinguish specific features of tumor elements similar in their cytological parameters. The differences in the character of hemopoiesis derangement in different forms of hemoblastoses can be used under clinical conditions for differential diagnosis of the leukemic stage of hematosarcomas and leukemias.

[Histiocytic proliferative diseases in children]. / Gistiotsitarnye proliferativnye zabolevaniia u detei.

The course of histioproliferative diseases was analyzed in 308 children treated at the All-Union Cancer Research Center, USSR AMS. Of these, there were 8 children with benign proliferation (Rosai-Dorfman disease). Histiocytosis-X was revealed in 232 children. The authors describe the regularities of histiocytic proliferation manifestations depending on the patients' age. Provide morphological (cytological) criteria for different types of histioproliferative diseases and characterize the treatment data.