The periodic acid‐schiff reaction and prognosis in children with acute lymphoblastic leukemia

Abstract

AbstractWe evaluated the intensity of the periodic acid‐Schiff (PAS) stain reaction by examining 200 lymphoblasts from the initial marrow aspirate specimen of 38 children with acute lymphoblastic leukemia (ALL). The patients were separated into low, intermediate, and high groups according to mean PAS score. The groups were then compared in terms of age, sex, initial hematologic values, T‐ and B‐lymphocyte markers, percentage of patients in remission six months after diagnosis, and percentage surviving. Significant differences were found between the low group and the other two groups with respect to sex, height of initial white blood cell (WBC) count, outlook for continued remission at six months, and overall survival (P < 0.05). The low‐score patients were predominantly males, whereas the other PAS‐score groups contained approximately equal numbers of males and females. The low‐score patients had a higher median initial WBC than the others, but all three groups had a similar proportion of patients with initial WBC under 20,000/cu mm. Low‐score patients were less likely to be in remission six months from diagnosis, and they had shorter survival than the intermediate‐ and high‐score patients (P < 0.05). The results suggest that children with ALL whose lymphoblasts stain weakly with PAS have a worse prognosis than those with intermediate or high PAS reactivity. PAS reactivity may vary independently of the WBC at diagnosis in children with ALL, because children with a low PAS score have a poor outlook even with initial WBC under 20,000/cu mm.