Acute lymphoblastic leukemia with the phenotype of a putative B‐cell/T‐cell bipotential precursor
Biphenotypic acute leukemias (BALs) are uncommon. Most are of myeloid‐B‐cell or myeloid‐T‐cell lineage. We report herein a 70‐year‐old man with an unusual acute leukemia where the blasts expressed both B‐ and T‐lymphoid markers. He presented to us with an enlarging cutaneous tumor. The presenting pe...
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Published in | American journal of hematology Vol. 77; no. 2; pp. 156 - 160 |
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Main Authors | , , , , , |
Format | Journal Article |
Language | English |
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Abstract | Biphenotypic acute leukemias (BALs) are uncommon. Most are of myeloid‐B‐cell or myeloid‐T‐cell lineage. We report herein a 70‐year‐old man with an unusual acute leukemia where the blasts expressed both B‐ and T‐lymphoid markers. He presented to us with an enlarging cutaneous tumor. The presenting peripheral blood and bone marrow aspirate showed 40% and 90% blasts, respectively, which were negative for the usual cytochemical stains. The flow cytometric analysis revealed that the blasts were positive for CD19, CD20, CD22, cytoplasmic (Cyt) CD79a, CD10, Cyt CD3, CD5, CD7, CD4, HLA‐DR, TdT, and were negative for myeloid markers. According to the scoring system from the European Group for the Immunological Characterization of Acute Leukaemias (EGIL), this case was an unequivocal B‐cell/T‐cell BAL. Conventional cytogenetic analysis revealed 46XY [t(4;11)(q31;q13), add(8)(q24), der(9)del(9)(p21)del(9)(q32q34), −13, +mar] in all 25 metaphases analyzed. Fluorescence in situ hybridization (FISH) and polymerase chain reaction (PCR) for 11q23 rearrangements as well as t(9;22) were negative. PCR for both TCR‐γ and IgH gene analyses revealed polyclonal rearrangements. We postulate that this case of BAL might have arisen from the putative common lymphoid progenitor cell. Am. J. Hematol. 77:156–160, 2004. © 2004 Wiley‐Liss, Inc. |
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AbstractList | Biphenotypic acute leukemias (BALs) are uncommon. Most are of myeloid-B-cell or myeloid-T-cell lineage. We report herein a 70-year-old man with an unusual acute leukemia where the blasts expressed both B- and T-lymphoid markers. He presented to us with an enlarging cutaneous tumor. The presenting peripheral blood and bone marrow aspirate showed 40% and 90% blasts, respectively, which were negative for the usual cytochemical stains. The flow cytometric analysis revealed that the blasts were positive for CD19, CD20, CD22, cytoplasmic (Cyt) CD79a, CD10, Cyt CD3, CD5, CD7, CD4, HLA-DR, TdT, and were negative for myeloid markers. According to the scoring system from the European Group for the Immunological Characterization of Acute Leukaemias (EGIL), this case was an unequivocal B-cell/T-cell BAL. Conventional cytogenetic analysis revealed 46XY [t(4;11)(q31;q13), add(8)(q24), der(9)del(9)(p21)del(9)(q32q34), -13, +mar] in all 25 metaphases analyzed. Fluorescence in situ hybridization (FISH) and polymerase chain reaction (PCR) for 11q23 rearrangements as well as t(9;22) were negative. PCR for both TCR-gamma and IgH gene analyses revealed polyclonal rearrangements. We postulate that this case of BAL might have arisen from the putative common lymphoid progenitor cell. Biphenotypic acute leukemias (BALs) are uncommon. Most are of myeloid‐B‐cell or myeloid‐T‐cell lineage. We report herein a 70‐year‐old man with an unusual acute leukemia where the blasts expressed both B‐ and T‐lymphoid markers. He presented to us with an enlarging cutaneous tumor. The presenting peripheral blood and bone marrow aspirate showed 40% and 90% blasts, respectively, which were negative for the usual cytochemical stains. The flow cytometric analysis revealed that the blasts were positive for CD19, CD20, CD22, cytoplasmic (Cyt) CD79a, CD10, Cyt CD3, CD5, CD7, CD4, HLA‐DR, TdT, and were negative for myeloid markers. According to the scoring system from the European Group for the Immunological Characterization of Acute Leukaemias (EGIL), this case was an unequivocal B‐cell/T‐cell BAL. Conventional cytogenetic analysis revealed 46XY [t(4;11)(q31;q13), add(8)(q24), der(9)del(9)(p21)del(9)(q32q34), −13, +mar] in all 25 metaphases analyzed. Fluorescence in situ hybridization (FISH) and polymerase chain reaction (PCR) for 11q23 rearrangements as well as t(9;22) were negative. PCR for both TCR‐ γ and IgH gene analyses revealed polyclonal rearrangements. We postulate that this case of BAL might have arisen from the putative common lymphoid progenitor cell. Am. J. Hematol. 77:156–160, 2004. © 2004 Wiley‐Liss, Inc. Biphenotypic acute leukemias (BALs) are uncommon. Most are of myeloid‐B‐cell or myeloid‐T‐cell lineage. We report herein a 70‐year‐old man with an unusual acute leukemia where the blasts expressed both B‐ and T‐lymphoid markers. He presented to us with an enlarging cutaneous tumor. The presenting peripheral blood and bone marrow aspirate showed 40% and 90% blasts, respectively, which were negative for the usual cytochemical stains. The flow cytometric analysis revealed that the blasts were positive for CD19, CD20, CD22, cytoplasmic (Cyt) CD79a, CD10, Cyt CD3, CD5, CD7, CD4, HLA‐DR, TdT, and were negative for myeloid markers. According to the scoring system from the European Group for the Immunological Characterization of Acute Leukaemias (EGIL), this case was an unequivocal B‐cell/T‐cell BAL. Conventional cytogenetic analysis revealed 46XY [t(4;11)(q31;q13), add(8)(q24), der(9)del(9)(p21)del(9)(q32q34), −13, +mar] in all 25 metaphases analyzed. Fluorescence in situ hybridization (FISH) and polymerase chain reaction (PCR) for 11q23 rearrangements as well as t(9;22) were negative. PCR for both TCR‐γ and IgH gene analyses revealed polyclonal rearrangements. We postulate that this case of BAL might have arisen from the putative common lymphoid progenitor cell. Am. J. Hematol. 77:156–160, 2004. © 2004 Wiley‐Liss, Inc. Biphenotypic acute leukemias (BALs) are uncommon. Most are of myeloid-B-cell or myeloid-T-cell lineage. We report herein a 70-year-old man with an unusual acute leukemia where the blasts expressed both B-and T-lymphoid markers. He presented to us with an enlarging cutaneous tumor. The presenting peripheral blood and bone marrow aspirate showed 40% and 90% blasts, respectively, which were negative for the usual cytochemical stains. The flow cytometric analysis revealed that the blasts were positive for CD19, CD20, CD22, cytoplasmic (Cyt) CD79a, CD10, Cyt CD3, CD5, CD7, CD4, HLA-DR, TdT, and were negative for myeloid markers. According to the scoring system from the European Group for the Immunological Characterization of Acute Leukaemias (EGIL), this case was an unequivocal B-cell/T-cell BAL. Conventional cytogenetic analysis revealed 46XY [t(4; 11)(q31; q13), add(8)(q24), der(9)del(9)(p21)del(9)(q32q34),-13, +mar] in all 25 metaphases analyzed. Fluorescence in situ hybridization (FISH) and polymerase chain reaction (PCR) for 11q23 rearrangements as well as t(9; 22) were negative. PCR for both TCR- gamma and IgH gene analyses revealed polyclonal rearrangements. We postulate that this case of BAL might have arisen from the putative common lymphoid progenitor cell. Am. J. Hematol. 77:156-160, 2004. |
Author | Tan, Lip Kun Koay, Evelyn S.C. Lau, Lee Gong Liu, Te Chih Tan, Suat Hoon Ee, Melvin H.L. |
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Keywords | Lymphoid cell Hematology Immunophenotype Acute Stem cell Precursor cell Hematopoietic cell Acute leukemia Malignant hemopathy acute lymphoblastic leukemia immunophenotyping Lymphoproliferative syndrome T-Lymphocyte Acute lymphocytic leukemia lymphoid progenitor cell |
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Snippet | Biphenotypic acute leukemias (BALs) are uncommon. Most are of myeloid‐B‐cell or myeloid‐T‐cell lineage. We report herein a 70‐year‐old man with an unusual... Biphenotypic acute leukemias (BALs) are uncommon. Most are of myeloid-B-cell or myeloid-T-cell lineage. We report herein a 70-year-old man with an unusual... |
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SubjectTerms | acute lymphoblastic leukemia Aged Antigens, CD - analysis Antigens, Neoplasm - analysis Antineoplastic Combined Chemotherapy Protocols - therapeutic use Biological and medical sciences Bone Marrow - pathology Fatal Outcome Flow Cytometry Gene Rearrangement, beta-Chain T-Cell Antigen Receptor - genetics Genes, Immunoglobulin - genetics Hematologic and hematopoietic diseases Humans Immunophenotyping In Situ Hybridization, Fluorescence Leukemia, Biphenotypic, Acute - diagnosis Leukemia, Biphenotypic, Acute - drug therapy Leukemia, Biphenotypic, Acute - genetics Leukemia, Biphenotypic, Acute - immunology Leukemia, Biphenotypic, Acute - pathology Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis Leukemic Infiltration lymphoid progenitor cell Male Medical sciences Polymerase Chain Reaction Skin - pathology |
Title | Acute lymphoblastic leukemia with the phenotype of a putative B‐cell/T‐cell bipotential precursor |
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