Granular acute lymphoblastic leukemia in children. "Aieop Cooperative Group for Cytology of Acute Leukemias".
BACKGROUND
Granular acute lymphoblastic leukemia (ALL) is a rare morphological variant of ALL, characterized by cytoplasmic azurophil granules or inclusions, positive for aspecific esterase and acid phosphatase, with heterogeneous features at the ultrastructural level.


METHODS
In an attempt to determine whether the presence of granules or inclusions marks a biologically distinct variety of ALL with peculiar clinical features, a prospective morphological review was undertaken of children entering AIEOP protocols for ALL in the period from 1985 to 1989.


RESULTS
Of 531 cases examined, 16 (3%) were found to have greater than 1% granular bone marrow blasts, with 7 cases (1.3%) having greater than 10%. The presence of granules or inclusions was associated with the immunophenotype of "common" ALL. There was no clear association with FAB type L1 or L2 nor with particular clinical or hematological findings at presentation. Complete remission was achieved in all cases; one patient died of infection in remission at 3 months and 2 patients relapsed after 12 and 32 months, respectively, while the others are still in remission after a minimum follow-up of 24 months.


CONCLUSIONS
In conclusion, granular morphology seems to have no prognostic importance in children ALL.
Invernizzi
R
R
Clinica Medica 2, Università di Pavia, Italy.
Rosanda
C
C
Basso
G
G
Conter
V
V
di Cataldo
A
A
Fenu
S
S
Forni
M
M
Frappampina
V
V
Granchi
D
D
Locatelli
F
F
D000135:Acid Phosphatase / Q000032:analysis; D000293:Adolescent; D000951:Antigens, Neoplasm / Q000032:analysis; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000032:analysis*; D001853:Bone Marrow / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D003594:Cytoplasmic Granules / Q000737:chemistry; D004253:DNA Nucleotidylexotransferase / Q000032:analysis; D006801:Humans; D007223:Infant; D009283:Naphthol AS D Esterase / Q000032:analysis; D009363:Neoplasm Proteins / Q000032:analysis; D014411:Neoplastic Stem Cells / Q000737:chemistry / Q000648:ultrastructure; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy / Q000401:mortality / Q000473:pathology*; D011446:Prospective Studies; D013194:Staining and Labeling; D016019:Survival Analysis
D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D009363:Neoplasm Proteins; D004253:DNA Nucleotidylexotransferase; D009283:Naphthol AS D Esterase; D000135:Acid Phosphatase