Recent thymic emigrants and prognosis in T- and B-cell childhood hematopoietic malignancies

Authors

  • Eleni Petridou,

    Corresponding author
    1. Department of Hygiene and Epidemiology, Athens University Medical School, Athens, Greece
    2. Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
    • Department of Hygiene and Epidemiology, Athens University Medical School, 75 M. Asias St., 11527 Athens, Greece
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    • Fax: +3010-7773840

  • Alexandra E. Klimentopoulou,

    1. Department of Hygiene and Epidemiology, Athens University Medical School, Athens, Greece
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  • Maria Moustaki,

    1. Department of Hygiene and Epidemiology, Athens University Medical School, Athens, Greece
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  • Leontios G. Kostrikis,

    1. Aaron Diamond AIDS Research Center, Rockefeller University, New York, NY, USA
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  • Angelos Hatzakis,

    1. Department of Hygiene and Epidemiology, Athens University Medical School, Athens, Greece
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  • Dimitrios Trichopoulos,

    1. Department of Hygiene and Epidemiology, Athens University Medical School, Athens, Greece
    2. Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
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  • Hellenic Pediatric Hematology Oncology Group

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    • The Hellenic Pediatric Hematology Oncology Group is composed of the following members: Fani Athanasiadou-Piperopoulou, Second Department of Pediatrics, Aristoteleion University of Salonica, AHEPA General Hospital, Salonica, Greece; Helen V. Kosmidis, Department of Pediatric Hematology-Oncology, A. Kyriakou Children's Hospital, Athens, Greece; Maria Kalmanti, Department of Pediatric Hematology-Oncology, University Hospital, Heraklion, Greece; John P. Panagiotou, Department of Pediatrics, Hematology-Oncology, Aghia Sophia Children's Hospital, Athens, Greece; Fotini Tzortzatou, Unit of Childhood Hematology-Oncology, First Department of Pediatrics, Athens University Medical School, Aghia Sophia Children's Hospital, Athens, Greece; Dimitrios Koliouskas, Department of Pediatrics, Hematology-Oncology, Ippokration General Hospital, Salonica, Greece.


Abstract

The concentration of T-cell receptor rearrangement excision DNA circles (TRECs) in peripheral blood mononuclear cells (PBMCs) is currently known to be a marker of recent thymic emigrants. We evaluated the hypothesis that TREC values would be lower in childhood T-cell hematopoietic malignancies than in childhood B-cell acute lymphoblastic leukemia (ALL) or healthy controls because the former category may reflect compromised thymic function. From the Greek national childhood leukemia/lymphoma database we obtained all 30 available T-cell leukemia/non-Hodgkin's lymphoma cases, 30 age- and sex-matched childhood B-cell origin cases of ALL and 60 healthy hospital controls. We compared TREC levels in PBMCs using a real-time PCR assay. There was highly significant reduction of TREC values in children with T-cell malignancies (median 3,100 TRECs/106 PBMCs), whereas children with B-cell origin ALL had slightly but nonsignificantly lower TREC values compared to healthy children (medians 19,300 and 22,500 TRECs/106 PBMCs, respectively). During a median follow-up period of about 19 months, only 4 children died. All of them had a T-cell hematopoietic malignancy and relatively low TREC values. The number of TRECs was higher among healthy girls than among healthy boys, and a similar pattern was evident in T-cell malignancies. It appears that there is a pattern of concordance of high TREC values with better disease prognosis in hematologic childhood malignancies. This applies to specific disease entities with better prognosis (B-cell origin ALL having higher TREC values than T-cell leukemia/lymphoma) and to gender, another important predictor of prognosis conditional on disease entity (girls having higher TREC values than boys); however, it may also be true for the survival of individual patients. These preliminary findings can be used as hypothesis-generating indications that should be confirmed in larger data sets. © 2002 Wiley-Liss, Inc.

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