Apoptotic cell identification: An in-vivo study during induction treatment of childhood acute lymphoblastic leukemia

  • Pudjo H Widjajanto
  • AJP Veerman
  • Sutaryo Sutaryo
Keywords: apoptotic cells detection, peripheral blood, treatment response, childhood acute lymphoblastic leukemia

Abstract

Background Acute lymphoblastic leukemia (ALL) in children has
high cure rate but it can cause death due to the side effects of
treatment or to the disease itself. Thus the evaluation on response
of treatment is important and may predict the prognosis. Since
apoptosis can be induced by chemotherapy, it is thought that the
number of leukemic cells that undergo apoptosis may reflect drug
sensitivity and cytoreduction rate, thus it may correlate with prog-
nosis.
Objective To detect apoptotic cells in peripheral blood of children
with ALL during the first week of treatment.
Methods We conducted a cross sectional study on 58 children
with newly diagnosed ALL treated in Department of Child Health,
Sardjito Hospital, Yogyakarta. Apoptotic cells were detected on
smears of buffy coat made from peripheral blod and stained with
May-Grunwald Giemsa. The apoptotic cells viewed under light mi-
croscope within 12 time points during 7 days after treatment started.
Results Apoptotic cells were identified in 3 of 58 patients with
index range of 4.2% to 36.2%.
Conclusion Apoptotic cells can be detected in peripheral blood
with simple method. The explanation of why not all blood smears
viewed showed these cells need further study. It may due to the
methods or the apoptotic process itself.

Author Biographies

Pudjo H Widjajanto
Department of Child Health, Medical School, Gajah Mada
University, Yogyakarta, Indonesia
AJP Veerman
Vrije Universiteit Medisch
Centrum, Amsterdam, The Netherlands
Sutaryo Sutaryo
Department of Child Health, Medical School, Gajah Mada
University, Yogyakarta, Indonesia

References

1. Smith MA, Gloeckler Ries MA. Childhood cancer:
Incidence, survival, and mortality. In: Pizzo PA, Poplack
DG, editors. Principles and practice of pediatric on-
cology. Philadelphia: Lippincott William & Wilkins;
2002. p. 1-12.
2. Pui CH, Crist WM. Acute lymphoblastic leukemia. In:
Pui CH, editor. Childhood leukemias. Cambridge:
Cambridge University Press;1999.
3. Margolin JF, Steuber CP, Poplack DG. Acute lympho-
blastic leukemia. In: Pizzo PA, Poplack DG, editors.
Principles and practice of pediatric oncology. Philadel-
phia: Lippincott William & Wilkins; 2002. p. 489-544.
4. Csoka M, Bocsi J, Falus A, Szalai C, Klujber V, Szende
B, et al. Glucocorticoid-induced apoptosis and treat-
ment sensitivity in acute lymphoblastic leukemia of
children. Pediatr Hem Oncol 1997;14:433-42.
5. Gajjar A, Ribeiro R, Hancock ML, Rivera GK,
Mahmoud H, Sandlund JT, et al. Persistence of circu-
lating blasts after 1 week of multiagent chemotherapy
confers a poor prognosis in childhood acute lympho-
blastic leukemia. Blood 1995;86:1292-5.
6. Gaynon PS, Bleyer WA, Steinherz PG, Finklestein JZ,
Littman P, Miller DR, et al. Day 7 marrow response an
outcome for children with acute lymphoblastic leuke-
mia and unfavorable presenting features. Med Pediatr
Oncol 1990;18:273-9.
7. Nachman J, Lukens J, Gaynon P, Magenis E, Wolff L,
Sather H, et al. Predictor of slow early response to BFM
induction therapy in children and young adults with
acute lymphoblastic leukemia. A report from children
cancer group (CCG). Blood 1990;80(Suppl I):257a.
8. Rautonen J, Hovi L, Siimes MA. Slow disappearance
of peripheral blast cells: An independent risk factor
indicating poor prognosis in children with acute
lymphoblastic leukemia. Blood 1988;71:989-91.
9. Sandlund JT, Harrison PL, Rivera G. Persistence of lym-
phoblasts in bone marrow on day 15 and day 22 to 25
of remission induction predicts a dismal treatment
outcome in children with acute lymphoblastic leuke-
mia. Blood 2002;100:43-7.
10. Schrappe M, Reiter A, Riehm H. Cytoreduction and
prognosis in childhood acute lymphoblastic leukemia.
J Clin Oncol1996;14:2403-6.
11. Schultz KR, Massing B, Spinelli JJ, Gaynon PS,
Wadsworth L. Importance of the day 7 bone marrow
biopsy as a prognostic measure of the outcome in chil-
dren with acute lymphoblastic leukaemia. Med Ped
Oncol 1997;29:16-22.
12. Steinherz PG, Gaynon PS, Breneman JC, Cherlow JM,
Grossman NJ, Kersey JH, et al. Cytoreduction and prog-
nosis in acute lymphoblastic leukemia-the importance
of early marrow response: Report from the childrens
cancer group. J Clin Oncol 1996;14:389-98.
13. Tsangaris GT, Stathopoulou FT. Development of a
quantitative method for the study apoptosis in periph-
eral blood. In vivo1996;10:435-44.
14. Schuler D, Szende B, Borsi JD, Marton T, Bocsi J,
Magyarossy E, et al. Apoptosis as a possible way of de-
struction of lymphoblasts after glucocorticoid treatment
of children with ALL. Pediatr Hematol Oncol
1994;11:641-9.
15. Kerr JFR, Winterford CM, Harmon BV. Apoptosis, its
significance in cancer and cancer therapy. Cancer
1994;73:2013-26.
16. Matsubara K, Kubota M, Adachi S. Induction of
apoptosis in childhood acute lymphoblastic leukemia
by chemotherapeutic agents: Failure to detect evidence
of apoptosis in vivo. Eur J Hematol 1994;52:47-52.
17. Tsangaris GT, Moschovi M, Mikraki V. Study of
apoptosis in peripheral blood of patients with acute
lymphoblastic leukemia during induction therapy. Anti
cancer 1996;16:3133-40.
Published
2016-10-18
How to Cite
1.
Widjajanto P, Veerman A, Sutaryo S. Apoptotic cell identification: An in-vivo study during induction treatment of childhood acute lymphoblastic leukemia. PI [Internet]. 18Oct.2016 [cited 16Apr.2024];46(5):195-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/928
Received 2016-10-15
Accepted 2016-10-15
Published 2016-10-18