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November 20, 2007 NEW YORK (Reuters Health) - A retrospective study of children diagnosed with T-cell precursor acute lymphoblastic leukemia (TCP ALL) concludes, based on PCR studies of stored neonatal blood spots, that most cases of the disease develop after birth, not in utero. In their report in the October 15th issue of Blood, the researchers note that TCP ALL accounts for about 15% of childhood ALL and comprises various genetically heterogeneous subforms. Previous research had indicated that many of the subtypes of B-cell precursor ALL begin during fetal life. To learn more about the timing of TCP ALL development, Dr. Renate Panzer-Grumayer of the Children's Cancer Research Institute, Vienna, and colleagues obtained dried neonatal blood spots (Guthrie cards) for 16 children diagnosed with TCP ALL at a median age of 3.2 years. Controls included peripheral blood from healthy donors and neonatal blood spots from healthy age-matched newborns. The researchers looked for 6 leukemia-specific markers and for 13 nononcogenic T-cell receptor rearrangements, using real-time quantitative polymerase chain reaction. Although the screening achieved a sensitivity capable of detecting 1 cell with a target marker in a background of 100,000 cells, the leukemic clone was present at birth in only 1 of the 16 cases. Because TCP ALL appears not to develop in utero in the majority of cases, the cause or causes of leukemia initiation presumably occur during postnatal life, Dr. Panzer-Grumayer told Reuters Health. "Furthermore, it can be assumed that the evolution to leukemia is more rapid than in B-lineage ALL and the pre-leukemic clone behaves differently." Copyright 2008 Reuters. Click for Restrictions.
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