Cell birth and death in childhood acute lymphoblastic leukaemia: how fast does the neoplastic cell clone expand?

In 23 children with untreated precursor B‐cell acute lymphoblastic leukaemia (ALL), the daily growth rate of the malignant cell clone was calculated. Cell birth expanded the leukaemic cell clone an average 10–11% per day, programmed cell death or apoptosis reduced the leukaemic cell mass by some 4% per day. From these two variables a net increase in the size of the leukaemic cell population of 6.9 ± 7.3% (range −1.2–27.3%) per day could be calculated. The daily growth rate correlated negatively with the logarithm of the duration of clinical symptoms before the diagnosis of ALL was established (r=−0.680; P = 0.0004). A long history, especially in children with undefined bone pain and arthralgias, was associated with a very slow expansion of the neoplastic cell clone.

[1]  Z. Darżynkiewicz,et al.  Evaluation of in vivo induction of apoptosis in patients with acute leukemia treated on a phase I study of paclitaxel. , 1995, Leukemia.

[2]  M. Melamed,et al.  Induction of DNA strand breaks associated with apoptosis during treatment of leukemias. , 1993, Leukemia.

[3]  B. Athreya,et al.  Differentiation of systemic juvenile rheumatoid arthritis from acute leukemia near the onset of disease. , 1993, The Journal of pediatrics.

[4]  Gerard I. Evan,et al.  Induction of apoptosis in fibroblasts by c-myc protein , 1992, Cell.

[5]  J. Gerdes,et al.  Cell cycle analysis in lymphoid neoplasia of childhood: differences among immunologic subtypes and similarities in the proliferation of normal and leukaemic precursor B cells , 1992, British journal of haematology.

[6]  Ó. Jónsson,et al.  Bone pain as an initial symptom of childhood acute lymphoblastic leukemia: association with nearly normal hematologic indexes. , 1990, The Journal of pediatrics.

[7]  W. Bursch,et al.  Determination of the length of the histological stages of apoptosis in normal liver and in altered hepatic foci of rats. , 1990, Carcinogenesis.

[8]  M. Greaves.  Differentiation-linked leukemogenesis in lymphocytes. , 1986, Science.

[9]  W. Earnshaw,et al.  Nuclear changes in apoptosis. , 1995, Current opinion in cell biology.

[10]  D. Harrison,et al.  Apoptosis: molecular aspects and pathological perspective , 1994 .

[11]  M. Andreeff.  Cell kinetics of leukemia. , 1986, Seminars in hematology.

[12]  P. Dörmer,et al.  In vivo production of childhood acute lymphoblastic leukemia cells in relation to ploidy and immunological subtype. , 1984, Leukemia research.