Medical College of Wisconsin
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Bone marrow stroma-supported culture of T-lineage acute lymphoblastic leukemic cells predicts treatment outcome in children: a Pediatric Oncology Group study. Leukemia 2002 Jun;16(6):1121-6 PMID: 12040442

Pubmed ID



Significant predictors of treatment outcome are poorly defined for patients with T-lineage acute lymphoblastic leukemia (T-ALL). A high WBC at diagnosis, which has traditionally been a predictor of poor response in T-ALL, has considerably weakened prognostic significance in the face of modern, more intensive chemotherapy. To test the hypothesis that bone marrow stroma-supported leukemic cell recovery might identify children at high risk for relapse, we measured the ex vivo recovery of T-ALL lymphoblasts from 29 newly diagnosed patients using a stromal cell co-culture assay. In all cases the T-ALL lymphoblasts showed an increase in recovery of T-ALL cells (RTC), ranging from 4 to 343%, in comparison to samples maintained without stroma. Since we were blinded to patient outcome in this case-control study, we then correlated patient outcome with RTC. The RTC for 18 patients in complete continuous remission (CCR) for greater than 4 years was stochastically larger than for the 11 patients who eventually relapsed (P = 0.011, by the two-sided Wilcoxon test). Furthermore, 100% of patients with an RTC of more than 26% had a CCR greater than 4 years while 78% of the patients with an RTC of less than 25% relapsed within 4 years. This is the first report to show that higher lymphoblast recovery may predict a more favorable outcome for children with T-ALL. A prospective study is needed to test whether stroma-supported leukemic cell recovery might serve as a basis for assigning risk-adjusted therapy.

Author List

Winter SS, Sweatman J, Shuster JJ, Link MP, Amylon MD, Pullen J, Camitta BM, Larson RS


Bruce M. Camitta MD Clinical Professor in the Medicine department at Medical College of Wisconsin


2-s2.0-85014264324   5 Citations

MESH terms used to index this publication - Major topics in bold

Bone Marrow Cells
Case-Control Studies
Cell Line
Cell Lineage
Cell Survival
Child, Preschool
Coculture Techniques
Leukemia-Lymphoma, Adult T-Cell
Leukocyte Count
Neoplasm Recurrence, Local
Stromal Cells
Treatment Outcome
Tumor Cells, Cultured
jenkins-FCD Prod-353 9ccd8489072cb19f5b9f808bb23ed672c582f41e