Relation between leukaemic cell count and degree of maturation in acute myeloid leukaemia

VLA molecule expression may be involved in the release of acute myeloid leukaemic cells from the bone marrow

Acute myeloid leukaemia (AML) cells have a variable capacity to egress from bone marrow into peripheral blood. This may be due to a variable lack of adhesion molecules on leukaemic cells. The expression of VLA1, 3, 4, 5, 6, beta 1-chain, LFA1, beta 2-chain, ICAM1 and NCAM appeared to be higher in bone marrow as compared to peripheral blood leukaemic cells, although this only reached significance for beta 1-chain (p less than 0.01). The number of cases with more than 20% positive cells in bone marrow leukaemic cells was lower in immature FAB-subtypes (M1, M5a) as opposed to more mature subtypes (M2, M3, M4, M5b) for the adhesion molecules tested. This reached significance for VLA5 (p less than 0.05) and beta 1-chain (p less than 0.007), while there was trend for VLA4. It is discussed that VLA4 and 5 may play a role in the release of leukaemic cells from the bone marrow.

Differences of cellular composition and adhesion molecule expression in "leukemic" as compared with "normal" human long-term bone marrow cultures

Human long-term bone marrow cultures (HLTBMCs) were established with bone marrow samples collected from 15 patients with acute myeloid leukemia (AML) and compared with HLTBMCs from eight healthy volunteers. During 6 weeks of culture, the cellular composition of HLTBMCs was quantitatively studied. The cells of the HLTBMCs were divided into three main categories: fibroblasts, macrophages, and 'other cells' (endothelial cells, hematopoietic cells and undefined cells). HLTBMCs derived from healthy volunteers demonstrated a very consistent development. The number of fibroblasts increased during culture and the number of macrophages decreased, resulting in a steady state after 3 weeks of culture. In contrast, HLTBMCs derived from patients with AML showed a strikingly different pattern of irregular development and a steady state was not reached under our conditions. The APAAP technique was used to demonstrate expression of adhesion molecules. VLA2, VLA5, VLA6, LFA1, Mac1, p150/95, beta 2-chain, HCAM, ICAM1, NCAM, and VCAM1 were more expressed on 'normal' as compared with 'leukemic' bone marrow stromal cells, although this reached significance only for beta 2-chain and NCAM. VLA1, 3, and 4 were expressed in a higher percentage on 'leukemic' stroma (not significant). More expression was seen on 'normal' as opposed to 'leukemic' macrophages for the adhesion molecules tested, except for VLA5. The differences reached significance for the majority of molecules tested. It is concluded that striking differences exist in cellular composition and adhesion molecule expression between HLTBMCs from healthy individuals and those from patients with AML. This may have an impact on the pathogenesis of AML.

Quantitative enzyme determination in acute myeloid leukemia

Freshly obtained leukemic cells from 64 patients with acute myeloid leukemia were investigated. Intracellular protein and enzyme content (myeloperoxidase (MPO), acid esterase with alpha naphthyl acetate (ANAE) and alpha naphthyl butyrate (ANBE) and lactate dehydrogenase) were measured together with the cell diameter and compared with FAB-classification, cytochemical staining and clinical features. Mean values of MPO and acid esterase discriminate between the pure myeloid leukemias, although overlap between various subgroups is considerable. No correlation between cytochemical and quantitative enzyme determination was found. The logistic regression analysis revealed a dependency of the occurrence of complete remission on protein and ANBE (p less than 0.01) content. We concluded that quantitative enzyme determination is an easily measurable parameter of maturation and may have prognostic significance.