Skip to main content
Log in

Extramedullary involvement in acute lymphoblastic leukemia and its relation to therapy

  • Original Articles
  • Published:
The Indian Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Extramedullary involvement (EMI) of various body sites was studied by doing CSF cytology anu FNAC of testes and lymph nodes in 82 children with acute lymphoblastic leukemia (ALL). Forty-five patients had received no therapy (group I) and 37 had been diagnosed and treated earlier and were now in remission (36) or relapse (group II). EMI was documented in 48.9% and 32.4% of patients of group I and II respectively. EMI was seen more frequently in patients with FAB-L 2 subtype (66.6%) as compared to FAB-L 1 subtype (34.6%) in group I. Lymph nodes and testes were commonly involved in group I and II patients respectively. Successful remission after complete chemotherapy was achieved in 82.5% of group I patients. However, successful remission rates were 95.2% in patients without any evidence of EMI versus 68.4% in those with EMI. These differences were also observed when response to therapy was analysed separately for patients with FAB-L1 and FAB-L2 subtypes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Jussawala DJ, Yeole BB, Natekar MV. Cancer in children in greater Bombay-1964–1972.Indian J Cancer 1975; 12: 135–143.

    Google Scholar 

  2. Dyment P, Sullivan HP, Hizdala E. Therapeutic manoeuvre and prolongation of remission in childhood lymphocytic leukemia with poor prognostic factor. Preliminary report.Proc Am Assoc Cancer Res 1979; 20: 190.

    Google Scholar 

  3. Miller DR. Acute lymphoblastic leukemia.Ped Clin N Am 1980; 27: 269–291.

    Article  CAS  Google Scholar 

  4. Shankar SK, Verma K. Cerebrospinal fluid cytology in patients with leukemia and lymphoma.Indian J Med Res 1980; 71: 90–95.

    CAS  PubMed  Google Scholar 

  5. Gill B, Kogan S, Rossman B et al. Needle biopsy in the diagnosis of testicular leukemia in children.J Urol 1989; 141: 1169–1171.

    CAS  PubMed  Google Scholar 

  6. Chessels JM. Acute lymphoblastic leumekia.Semin Hematol 1982; 19: 155–171.

    Google Scholar 

  7. Choudhury VP, Arya LS, Marwaha RK. Acute leukemia in children.Indian Pediatr 1988; 25: 734–739.

    Google Scholar 

  8. Poplack GD, Cassady JR, Pizzo AP. Leukemia and lymphoma of childhood. In: De Vita TV, Hellman S, Rosenberg SH, eds.Cancer: Principle and Practice of Oncology. Philadelphia: JB Lippincott Co. 1985; 1591–1621.

    Google Scholar 

  9. Miller DR, Leikin S, Albo V. Prognostic significance of lymphoblast morphology in childhood leukemia.Proc Am Soc Clin Oncol 1979; 20: 345.

    Google Scholar 

  10. Bennet JM, Catovsky D, Daniel MT et al. The morphological classification of acute lymphoblastic leukemia. Concordance among observers and clinical correlation.Br J Hematol 1981; 47: 553–561.

    Article  Google Scholar 

  11. Nies BA, Malingren RA, Chu EW et al. Cerebrospinal fluid cytology in patients with acute leukemia.Cancer 1965; 18: 1385–1391.

    Article  CAS  PubMed  Google Scholar 

  12. Mathe G, Schwarzenberg L, Mery AM et al. Extensive histological and cytological survey of patients with acute leukemia on complete remission.Br Med J 1966; 1: 640–642.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Ortega JA, Nesbit HE, Donaldson MHL. Asparginase, vincristine and prednisolone for induction of first remission in ALLCancer Res 1977; 37: 535–540.

    CAS  PubMed  Google Scholar 

  14. Dacie JV, Lewis SM, Catovsky D. Blood cell chemistry and supplementary techniques. In: Dacie JV, Lewis SM, eds.Practical Hematology. Edinburgh: Churchill Livingstone, 1984; 84–116.

    Google Scholar 

  15. Viana MB, Mauberi HS, Terene C. Subclassification of ALL in children. Analysis of the reproductivity of morphological criteria and prognostic implication.Br J Hematol 1980; 44: 383–388.

    Article  CAS  Google Scholar 

  16. Miller DR, Leikin S, Albo V et al. Prognostic importance of morphology (FAB classification) in acute lymphoblastic leukemia.Br J Hematol 1981; 48: 199–206.

    Article  CAS  Google Scholar 

  17. Keletti J, Revex T, Scholar D. Morphological diagnosis in childhood leukemia.Br J Hematol 1972; 40: 501–502.

    Article  Google Scholar 

  18. Kim TH, Byrness RK, Lui VKS et al. Pretreatment testicular biopsy in childhood acute lymphocytic leukemia.Lancet 1981; 2: 657–658.

    Article  CAS  PubMed  Google Scholar 

  19. Harousseaou JL, Tobelam G, Schaison B. High risk acute lymphocytic leukemia. A study of 141 cases with initial WBC count over 100,000.Cancer 1980; 46: 1996–2003.

    Article  Google Scholar 

  20. Kuo TT, Tschang TP, Chu JY. Testicular, relapse in childhood acute lymphocytic leukemia during bone marrow remission.Cancer 1976; 38: 2604–2612.

    Article  CAS  PubMed  Google Scholar 

  21. Stoffel TJ, Nesbit ME, Levitt SH. Extramedullary involvement of the testes in childhood leukemia.Cancer 1975; 35: 1203–1211.

    Article  CAS  PubMed  Google Scholar 

  22. Layfield LJ, Hilborne LH, Ljung B et al. Use of FNAC for the diagnosis of testicular relapse in patients with ALL.J Urol 1988; 139: 1020–1022.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Vani Rao, A., Verma, K., Kapila, K. et al. Extramedullary involvement in acute lymphoblastic leukemia and its relation to therapy. Indian J Pediatr 58, 535–541 (1991). https://doi.org/10.1007/BF02750938

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02750938

Key Words

Navigation