Recent Advances in Cell Biology of Acute Leukemia: Impact on Clinical Diagnosis and Therapy

This volume gives an overview of the state of the art regarding cell-biological features of acute leukemias. Based on survey articles and results of clinical multicenter studies in children and adults with ALL or AML, it offers a detailed presentation concerning the significance of immunologic, cytogenetic and molecular-biologic analyses in the classification of acute leukemia and the identification of clinical risk groups. Current immunological and molecular-biological techniques for detecting minimal residual disease are described and their possibilities and limitations discussed. Further main topics include preclinical investigations and first clinical experience with interleukin 2-based immunotherapy in acute leukemia, biological features of new hematopoietic growth factors and recent advanced in the molecular understanding of the genetic defects in leukemic cells.

The development of new techniques such as immuno- phenotyping, cytogenetic investigations and, more recently, molecular studies has considerably increased our diagnostic repertoire and broadened our ideas about the biology of acute leukemias. While immunophenotyping with mono- clonal antibodies has yielded increased diagnostic precision and made it possible to develop a highly reproducible classification of acute leukemias based on cell-biological features, further insights have been gained into the patho- genetic mechanisms involved in leukemogenesis by means of cytogenetic detection of acquired structural chromosomal abnormalities. Analysis of the leukemia-associated chromo- somal breakpoints using molecular techniques can now pinpoint many genomic sites essential for normal develop- ment and maturation of hematopoietic cells but functionally disrupted in leukemic cells. The main goal of the international workshop that we held in Berlin with a select group of scientists and clinicians involved in leukemia research was to describe the state of the art and new developments in the immunologic, cytogenetic, and molecular characterization of acute leukemias and to discuss the clinical importance of cell- biological features. After introductory survey lectures dealing with the immunological and molecular-biological characteristics of normal vs. malignant lymphatic and myeloid progenitor cells, the workshop centered on con- tributions characterizing the immunophenotype and both numerical and structural chromosomal abnormalities in acute leukemias.

Contents Hematopoietic Differentiation.- Phenotypic Heterogeneity in Acute Leukemias, Immunological Characterization and Clinical Relevance.- Biological and Clinical Significance of Cytogenetic Abnormalities in Acute Leukemias.- Minimal Residual Disease in Acute Leukemias, Detection and Immunotherapeutic Strategies.- Immunophenotypic and Molecular Genetic Characterization of Acute Lymphoblastic Leukemia.- Leukemic Cell Characterization in Acute Myeloid Leukemia.-