Vascular density in childhood acute lymphoblastic leukaemia correlates to biological factors and outcome.
The issue of angiogenesis and its clinical relevance in childhood acute lymphoblastic leukaemia (ALL) is controversial. In the present study, microvessel density (MVD), analysed in 185 diagnostic bone marrow biopsies, was higher in T-cell ALL compared to B-cell precursor (BCP)-ALL (P = 0.013). In the BCP group, cases with t(12;21) were characterized by a low MVD while patients with high-hyperdiploid leukaemia (HeH, 51-61 chromosomes) showed a high MVD compared to other BCP patients (P = 0.001 and 0.002 respectively). There was a correlation between MVD and white blood cell (WBC) count in high-risk BCP patients (P = 0.021). In addition, BCP patients with a high marrow reticulin fibre density and high MVD had an unfavourable outcome compared to the other BCP patients (P = 0.002). The fraction of vessels in which lumina were filled with blasts (blast congested vessel fraction) correlated strongly with WBC count (P < 0.001). These findings indicate that the angiogenic process interacts with other stroma-factors, such as reticulin fibre density, in its effect on outcome, and is coupled to both the ALL genotype and phenotype. One possible implication is that different subtypes of childhood ALL may respond differently to anti-angiogenic drugs as a supplement in first-line treatment.
Norén-Nyström
Ulrika
U
Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden. ulrika.norennystrom@pediatri.umu.se
Heyman
Mats
M
Frisk
Per
P
Golovleva
Irina
I
Sundström
Christer
C
Porwit
Anna
A
Roos
Göran
G
Bergh
Anders
A
Forestier
Erik
E
D000293:Adolescent; D001856:Bone Marrow Examination; D002648:Child; D002675:Child, Preschool; D050676:Core Binding Factor Alpha 2 Subunit / Q000235:genetics; D020732:Cytogenetic Analysis; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D055806:Microvessels / Q000473:pathology*; D009389:Neovascularization, Pathologic; D015514:Oncogene Proteins, Fusion / Q000235:genetics; D015452:Precursor B-Cell Lymphoblastic Leukemia-Lymphoma / Q000276:immunology / Q000473:pathology; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000276:immunology / Q000401:mortality / Q000473:pathology*; D054218:Precursor T-Cell Lymphoblastic Leukemia-Lymphoma / Q000276:immunology / Q000473:pathology; D011379:Prognosis; D016016:Proportional Hazards Models; D012155:Reticulin / Q000648:ultrastructure; D020133:Reverse Transcriptase Polymerase Chain Reaction / Q000379:methods; D012306:Risk; D016019:Survival Analysis; D000097764:ETS Translocation Variant 6 Protein
D050676:Core Binding Factor Alpha 2 Subunit; D015514:Oncogene Proteins, Fusion; D012155:Reticulin; C102421:TEL-AML1 fusion protein; D000097764:ETS Translocation Variant 6 Protein