Chronic and Acute Leukemias in Adults

372 Pages·1985·8 MB·English

by  Eric H. Westin

Chronic and Acute Leukemias in Adults
Cancer Treatment and Research
WILLIAM L MCGUIRE, series editor
Livingston RB (ed): Lung Cancer I. 1981. ISBN 90-247-2394-9.
Bennett Humphrey G, Dehner LP, Grindey GB, Acton RT (eds): Pediatric Oncology I. 1981.
ISBN 90-247-2408-2.
DeCosse 11, Sherlock P (eds): Gastrointestinal Cancer I. 1981. ISBN 90-247-2461-9.
Bennett JM (ed): Lymphomas 1, including Hodgkin's Disease. 1981. ISBN 90-247-2479-1.
Bloomfield CD (ed): Adult Leukemias I. 1982. ISBN 90-247-2478-3.
Paulson DF (ed): Genitourinary Cancer I. 1982. ISBN 90-247-2480-5.
Muggia FM (ed): Cancer Chemotherapy I. ISBN 90-247-2713-8.
Bennett Humphrey G, Grindey GB (eds): Pancreatic Tumors in Children. 1982. ISBN 90-247-2702-2.
Costanzi 11 (ed): Malignant Melanoma I. 1983. ISBN 90-247-2706-5.
Griffiths CT, Fuller AF (eds): Gynecologic Oncology. 1983. ISBN 0-89838-555-5.
Greco AF (ed): Biology and Management of Lung Cancer. 1983. ISBN 0-89838-554-7.
Walker MD (ed): Oncology of the Nervous System. 1983. ISBN 0-89838-567-9.
Higby DJ (ed): Supportive Care in Cancer Therapy. 1983. ISBN 0-89838-569-5.
Herberman RB (ed): Basic and Clinical Tumor Immunology. 1983. ISBN 0-89838-579-2.
Baker LH (ed): Soft Tissue Sarcomas. 1983. ISBN 0-89838-584-9.
Bennett JM (ed): Controversies in the Management of Lymphomas. 1983. ISBN 0-89838-586-5.
Bennett Humphrey G, Grindey GB (eds): Adrenal and Endocrine Tumors in Children. 1983.
ISBN 0-89838-590-3.
DeCosse 11, Sherlock P (eds): Clinical Management of Gastrointestinal Cancer. 1984.
ISBN 0-89838-601-2.
Catalona W J, Ratliff TL (eds): Urologic Oncology. 1984. ISBN 0-89838-628-4.
Santen RJ, Manni A (eds): Diagnosis and Management of Endocrine-related Tumors. 1984.
ISBN 0-89838-636-5.
Costanzi JJ (ed): Clinical Management of Malignant Melanoma. 1984.
ISBN 0-89838-656-X.
Wolf GT (ed): Head and Neck Oncology. 1984. ISBN 0-89838-657-8.
Alberts DS, Surwit EA (eds): Ovarian Cancer. 1985. ISBN 0-89838-676-4.
Muggia FM (ed): Experimental and Clinical Progress in Cancer Chemotherapy. 1985.
ISBN 0-89838-679-9.
Higby DJ (ed): The Cancer Patient and Supportive Care. 1985. ISBN 0-89838-690-X.
Bloomfield CD (ed): Chronic and Acute Leukemias in Adults. 1985. ISBN 0-89838-702-7.
Chronic and Acute Leukemias
in Adults
edited by
CLARA D. BLOOMFIELD
University of Minnesota School of Medicine
Section of Medical Oncology
Minneapolis, Minnesota
U.S.A.
1985 MARTINUS NIJHOFF PUBLISHERS ~ ..
GRoup.1I
a member of the KLUWER ACADEMIC PUBLISHERS
BOSTON / DORDRECHT / LANCASTER .~
Distributors
for the United States and Canada: Kluwer Academic Publishers, 190 Old Derby
Street, Hingham, MA 02043, USA
for the UK and Ireland: Kluwer Academic Publishers, MTP Press Limited,
Falcon House, Queen Square, Lancaster LA 1 1R N, UK
for all other countries: Kluwer Academic Publishers Group, Distribution Center,
P.O. Box 322, 3300 AH Dordrecht, The Netherlands
Library of Congress Cataloging in Publication Data
Main entry under title:
Chronic and acute leukemias in adults.
(Cancer treatment and research)
1. Leukemia. I. Bloomfield, Clara D.
II. Series. [DNLM: 1. Leukemia in adulthood.
W1 CA693 I WH 250 C5536]
RC643.C48 1985 616.99'49 84-22711
ISBN 978-1-4612-9619-5 ISBN 978-1-4613-2581-9 (eBook)
DOI 10.1007/978-1-4613-2581-9
Copyright
© 1985 by Martinus Nijhoff Publishers, Boston.
Softcover reprint of the hardcover 1s t edition 1985
All rights reserved. No part of this publication may be reproduced, stored in a
retrieval system, or transmitted in any form or by any means, mechanical,
photocopying, recording, or otherwise, without the prior written permission of
the publishers,
Martinus Nijhoff Publishers, 190 Old Derby Street, Hingham, MA 02043, USA.
Contents
Foreword . XIII
Preface XV
I. Retroviruses and One Genes in Human Leukemias and Lympho
mas (E. H. WESTIN, F. WONG-STAAL and R. C. GALLO)
l.l Introduction ........ I
1.2 One Genes in Leukemogenesis 2
1.2.1 Introduction . . . . . . 2
1.2.2 Retroviral Derived Cellular One Genes 2
1.2.2.1 Genetic Structure of Defective, Acutely Trans-
forming Viruses . . . . . . . . . . . . . .. 2
1.2.2.2 Cellular Origin of the Retroviral Transforming
Genes ................... 2
1.2.2.3 Cloning and Properties of the Human Homolo-
gues of Retroviral One Genes ........ 3
1.2.2.4 Studies of Expression of the Human Homologues
of the Viral One Genes in Leukemias and Lym-
phomas .................. 3
1.2.2.5 Amplification as a Mechanism of Activation of
Cellular One Genes . . . . . . . . . . . .. 5
1.2.2.6 Correlation of One Gene Localization with Chro-
mosomal Translocations . . . . . . . . . .. 6
1.2.3 Potential Transformation Genes Detected by Transfec-
tion Techniques .... . . . . . . . . . . . . .. 7
1.2.3.1 Use of Transfection Techniques to Detect Poten-
tial Activated Transforming Genes . . . . .. 7
1.2.3.2 Detection of Activated Ras One Gene Family
Members by Use of the NIH 3T3 Transfection
System . . . . . .. ........... 8
VI
1.2.3.3 Detection of an Activated Gene Related to
Transferrin in Avian Bursal Lymphomas . .. 9
1.2.3.4 Multiple Genetic Alterations are Required to
Transform Normal Diploid Cell Lines that are
not Immortalized . . . . . . . . . . . . .. 10
1.2.3.5 Future Directions in Use of Transfection Systems
for Detection of Activated Transforming Genes 11
1.3 Retroviruses in Human Leukemia-Lymphoma . . . . . .. 12
1.3.1 Background Considerations . . . . . . . . . . . .. 12
1.3.2 Growth of Mature Human T -Cells Growth Factor
(TCGF) and the Isolation of the First Human Retrovi-
ruses (HTLV ) .................. 12
1.3.3 Seroepidemiology of HTLV . . . . . . . . . . . .. 14
1.3.3.1 Characteristics of HTLV Associated Diseases . 14
1.3.3.2 Antibodies to HTLV in the Normal Population
and Healthy Relatives of AT L Patients . . .. 15
1. 3.4 Molecular Epidemiology of HTLV -Related Diseases 16
1.3.5 In Vitro Transformation of Normal Cold Blood T-cells
by HTLV . . . . . . . . . . . . . . . . . . 17
1.3.6 Possible Mechanisms for HTLV Transformation .... 19
Acknowledgements 20
References .. . . . . . . . . . . . . . . . . .. 20
2. Study of Differentiation and Proliferation of Leukemic Cells Using
Myeloid Leukemia Cell Lines (H. PHILLIP KOEFFLER) ..... 27
2.1 Introduction: Establishment of Human Myeloid Leukemia
Cell Lines ....................... 27
2.2 Human Erythroleukemia Cell Lines .................... 32
2.3 Study of Granulocyte Dltlerentiation Using Myeloid Leukemic
Cell Lines ....................... 33
2.3.1 Nonphysiological Inducers of Granulocyte differentia-
tion . . . . . . . . . . . . . . . . . . . . . . .. 34
2.3.2 Physiological Inducers of Granulocyte Differentiation of
HL-60 Cells . . . . . . . . . . . . 44
2.3.2.1 Differentiation Inducing factor 44
2.3.2.2 Retinoids ......... 45
2.3.2.3 Vitamin D Metabolites 47
2.3.2.4 Miscellaneous Physiological Inducers of Myeloid
Leukemia Differentiation . . . . . . .. 48
2.3.3 Therapeutic Implications of Inducers of Granulocyte
Differentiation of HL-60 .. . . . . .. .... 49
2.4 Induction of Macrophage-Like Differentiation of Human
Acute Myelogenous Cells . . . . . . . . . .. .... 51
VII
2.4.1 Phorbol Diesters . . . . . . . . . . 51
2.4.2 Teleocidins ............ 54
2.5 Genetic Analysis of Myeloid Differentiation 55
2.6 Hormonal Modulation of Leukemic Cell Growth 56
2.7 An In Vitro Model for Chemotherapy of Acute Myelogenous
Leukemia . . . . . 59
2.8 Conclusion .... 60
Acknowledgements 61
References . . . . 61
3. Biological Markers in Lymphoproliferative Disorders
(D. CATOVSKY, J.V. MELO and E. MATuTEs) ................ 69
3.1 Introduction ........... 69
3.2 Immunological Markers ...... 70
3.2.1 Conventional Band T Markers 70
3.2.2 McAb to B-Cell Antigens . . . 72
3.2.3 McAb Reactive with Band T cells 75
3.2.4 McAb to T-Cell Antigens . . . . 76
3.2.5 McAb to Cell' Specific' Antigens 79
3.2.6 T-Functional Assays . . . . . 81
3.2.7 B-Cell Differentiation In Vitro 82
3.3 Chronic B-Cell Malignancies . . . . 83
3.3.1 B-Cell Lymphocytic Leukemia (B-CLL) 84
3.3.2 B-Prolymphocytic Leukemia (B-PLL) 85
3.3.3 Hairy Cell Leukemia (HCL) ..... 86
3.3.4 Non-Hodgkin Lymphomas (NHL) . . . 87
3.3.5 Lymphoplasmacytic Lymphoma (LPL) ............ 87
3.4 Chronic T-Cell Malignancies . . . . . . . . . . 88
3.4.1 T -Chronic Lymphocytic Leukemia (T -CLL) 88
3.4.2 T-Prolymphocytic Leukemia (T-PLL) 89
3.4.3 Cutaneous T-Cell Lymphomas (CTCL) 90
3.4.4 Adult T-Cell Leukemia/Lymphoma (A TTL) 90
3.5 Cytochemistry of Acid Hydrolases ...... 92
3.5.1 Acid Phosphatase (AP) . . . . . . . . . 92
3.5.2 Alpha-Naphthyl Acetate Esterase (ANAE) 94
3.5.3 Dipeptidylaminopeptidase IV (DAP IV) 94
3.5.4 Other Acid Hydrolases . 95
3.6 Chromosomes . . . . . . . . 95
3.6.1 Abnormalities in B-CLL 96
3.6.2 Abnormalities in B-PLL 98
3.6.3 Abnormalities in HCL . 98
3.6.4 Abnormalities in NHL . 98
3.6.5 Abnormalities in T-Cell Leukemias and CTCL 99
VIII
3.7 Conclusions . . . . 100
Acknowledgements 101
References .... 10 1
4. Surface Marker Analysis of Acute Myeloblastic Leukemia
(JAMES D. GRIFFIN) ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 113
4.1 Introduction .................... 113
4.2 Differentiation of Normal Myeloid Cells ......... 114
4.3 Detection of Myeloid-Lineage Antigens by Heteroantisera 116
4.4 Production of Monoclonal Antibodies to Myeloid Cell Surface
Antigens ....................... 117
4.5 Monoclonal Antibodies Reactive with Human AML Cells 119
4.5.1 B4.3, B13.9, B2.12 . . . 119
4.5.2 B9.8, B13.4, B34.3, B43.4 119
4.5.3 D5 . 121
4.5.4 D5D6 . . . . . . . . . 121
4.5.5 5F1 . . . . . . . . . . 121
4.5.6 FMC10, FMC11, FMC12, FMC13 121
4.5.7 1G10 . . . . . . 121
4.5.8 80H1, 80H3, 80H5 122
4.5.9 L4F3 . 122
4.5.10 MMA 122
4.5.11 Mol 122
4.5.12 Mo2 123
4.5.13 M03 123
4.5.14 M04 123
4.5.15 M05 123
4.5.16 My-1 123
4.5.17 My3, My4 123
4.5.18 My7 124
4.5.19 My8 . 124
4.5.20 My9 . 125
4.5.21 My10 125
4.5.22 PMN6, PMN29, PM81, and AML-2-23 125
4.5.23 TG1 . . . . . . . . . . . . . 125
4.5.24 UCHM1, UCHALF . . . . . . 126
4.6 Expression of Myeloid Differentiation Antigens on AML
Cells . . . . . . . . . . . . . . . . . . . . . . . . . . 126
4.6.1 Expression of Myeloid Differentiation Antigens on Cul-
tured Human Myeloid Cell Lines " . . . . . . . . 126
4.6.2 Expression of Myeloid Antigens on Cells From Acute
Myeloblastic Leukemia Patients . . . . . . . . . . . 128
IX
4.6.3 Use of Myeloid Monoclonal Antibodies to Identify Sub-
groups of AML 132
4.7 Future Directions ........ . . . . . . . . . . . . 138
References . . . . . . . . . . . . . . . . . . . . . . . 140
5. Classification of 358 Cases of Acute Myeloid Leukemia by FAB
Criteria: Analysis of Clinical and Morphologic Features
(M. STANLEY, R.W. McKENNA, G. ELLINGER and R.D. BRUN-
NING) .................................................. 147
5.1 Introduction ...................... 147
5.2 Clinical and Morphologic Characteristics of the F AB Classes 149
5.2.1 FAB-Ml: Acute Myeloid Leukemia Without Matura-
tion . . . . . . . . . . . . . . . . . . . . . .. 149
5.2.2 F AB-M2: Acute Myeloid Leukemia With Maturation 150
5.2.3 FAB-M3: Acute Pro myelocytic Leukemia ..... 152
5.2.4 FAB-M4: Acute Myelomonocytic Leukemia . . .. 155
5.2.5 FAB-M5A: Acute Monocytic Leukemia Poorly Differen-
tiated (Mono blastic) ............................ 157
5.2.6 FAB-M5B: Acute Monocytic Leukemia with Differentia-
tion . . . . . . . . . . . . . 159
5.2.7 F AB-M6: Erythroleukemia . . 161
5.3 Comparison of FAB Classes of AML 163
5.3.1 Age and Sex Distribution . . . 164
5.3.2 Clinical and Laboratory Findings 164
5.3.3 Morphologic Findings 166
5.3.4 Survival 166
5.4 Discussion ........ 168
References . . . . . . . . 172
6. Chemosensitivity of In Vitro Colony Forming Units as a Predictor
of Response to Antileukemic Drugs (1.1. HUTTON) ..... .... .. 175
6.1 Introduction .... 175
6.2 Colony Assays ..................... 176
6.2.1 General Features . . . . . . . . . . . . . . . . . . 176
6.2.2 Colony Assay of Blasts in Acute Myelogenous Leuke-
mia ........................................... 177
6.2.3 Colony Assay of Blasts in Acute Lymphoblastic Leuke-
mia . . . . . . . . . . . . . . . . . . . . . 181
6.3 Quantitation of Sensitivity to Antileukemic Drugs . . . . . 182
6.3.1 In Vitro Clonogenic Assays of Drug Sensitivities . . . 183
6.3.2 Differential Sensitivities of Normal and Leukemic Colo-
ny Forming Units ............ . 187
6.3.3 Effects of Drugs on Capacity for Self-Renewal 190
x
6.3.4 What is a 'Drug Resistant' L-CFU? ........ 191
6.4 Correlations Between In Vitro Chemosensitivities of L-CFU
and Clinical Response of the Patient .... 194
6.4.1 Clinical Drug Resistance ....... 195
6.4.2 Drug Resistance and Treatment Failure 195
6.4.3 L-CFU Assays and Clinical Trails . . . 197
6.4.4 L-CFU Growth In Vitro and Outcome of Therapy 198
6.4.5 Chemosensitivities of L-CFU In Vitro and Outcome of
Therapy 201
6.5 Summary . 205
References . 205
7. Post-Remission Therapy for Acute Myelogenous Leukemia
(W.R. VOGLER) ......................................... 209
7.1 Introduction ................... 209
7.2 Role of Induction Therapy on Remission Duration .... 209
7.3 Role of Consolidation Therapy on Remission Duration 212
7.4 Role of Maintenance Chemotherapy in Prolonging Remis-
sions ............................................... 214
7.5 The Role of Immunotherapy in Maintenance ....... 216
7.6 Prognostic Variables Predicting for Prolonged Remission Du-
ration ............. 218
7.7 Central Nervous System Leukemia 220
7.8 Bone Marrow Transplantation 221
7.9 Summary and Conclusions 221
Acknowledgement 222
References ...... 222
8. The Role of Marrow Transplantation in the Treatment of Leuke-
mia (F.R. ApPELBAUM and E.D. THOMAS) .................. 229
8.1 Introduction .... 229
8.2 Donor Selection . . . . . . . . . . . 231
8.3 Preparative Regimens ........ 232
8.4 Techniques of Marrow Transplantation 233
8.5 Clinical Results in Acute Nonlymphoblastic Leukemia (ANL) 233
8.5.1 Refractory ANL . . . . 233
8.5.2 First Remission of ANL ...... 234
8.5.3 After First Relapse . . . . . . . . . 237
8.5.4 The Role of Transplantation in ANL 237
8.6 Clinical Results in Acute Lymphoblastic Leukemia (ALL) 241
8.6.1 Refractory ALL .......... 241
8.6.2 Remission ALL .......... 242
8.6.3 The Role of Transplantation in ALL 242