title: Initial prognostic factors and lymphoblast-erythrocyte rosette formation in 109 children with acute lymphoblastic leukemia.
abstract: Bone marrow lymphoblasts from 109 children admitted with untreated acute lymphoblastic leukemia (ALL) were tested for spontaneous rosette formation with sheep erythrocytes. Twenty-six children (24%) had lymphoblasts that formed rosettes (E+). Of 13 initial clinical characteristics, 8 were significantly associated with E+ lymphoblasts: mediastinal enlargement (86% of patients E+), leukocyte counts over 100 X 10(9)/liter (65% E+), nodes greater than 2 cm in any diameter (65% E+), age over 5 yr (46% E+), hemoglobin over 8 g/dl (44% E+), hepatomegaly greater than 5 cm (38% E+), boys (35% E+), and lymph node enlargement outside of the cervical area (28% E+). Spleen size, initial platelet counts, and periodic acid-Schiff scores did not distinguish E+ from E- patients. Since few patients were black and few presented with central nervous system leukemia, the association of these two characteristics with E+ blasts could not be determined. A hierarchical classification scheme and a linear logistic regression model were used to define the patterns of characteristics associated with E+ lymphoblasts. The initial clinical characteristics and the poorer course of E+ patients suggest that ALL comprises at least two biologically and clinically distinct types. The E+ ALL may result from a leukemic transformation of a non-Hodgkin lymphoma.
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004358:Drug Therapy; D004359:Drug Therapy, Combination; D004912:Erythrocytes / Q000276:immunology; D005260:Female; D006454:Hemoglobins; D006529:Hepatomegaly / Q000150:complications; D006801:Humans; D007223:Infant; D007945:Leukemia, Lymphoid / Q000175:diagnosis / Q000276:immunology* / Q000628:therapy; D007958:Leukocyte Count; D008198:Lymph Nodes / Q000033:anatomy & histology; D008297:Male; D008482:Mediastinum / Q000033:anatomy & histology; D011379:Prognosis; D011878:Radiotherapy; D012044:Regression Analysis; D012397:Rosette Formation
chemical_list: D006454:Hemoglobins