Details

Autor(en) / Beteiligte

• Cross, Anne H.
• Goorha, Rakesh M.
• Nuss, Rachelle
• Behm, Frederick G.
• Murphy, Sharon B.
• Kalwinsky, David K.
• Raimondi, Susana
• Kitchingman, Geoffrey R.
• Mirro, Joseph

Titel

Acute Myeloid Leukemia With T-Lymphoid Features: A Distinct Biologic and Clinical Entity

Ist Teil von

• Blood, 1988-08, Vol.72 (2), p.579-587

Ort / Verlag

Washington, DC: Elsevier Inc

Erscheinungsjahr

1988

Link zum Volltext

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• We studied the clinical and biologic features of 10 cases of acute leukemia that met standard French-American-British (FAB) criteria for acute myeloid leukemia (AML) but in which the blast cells also expressed the T-cell-associated CD2 surface antigen. All cases had >3% myeloperoxidase and Sudan black B-positive leukemic blasts, and blasts from seven cases contained Auer rods. Reactivity of the cells with a panel of monoclonal antibodies (MAbs) indicated that leukemic cells in all cases expressed myeloid- associated (CD11b, CD13) surface antigens, further supporting the diagnosis of AML. However, blasts from every patient coexpressed the T-cell-associated surface CD2 and CD7 as well as cytoplasmic CD3 antigens. Blasts from five patients expressed surface CD25, whereas blasts from only one expressed surface CD3. Five patients had rearranged T-cell receptor β -chain genes, whereas only three had rearranged T-cell receptor γ-chain genes. This pattern of lineage-related gene expression appears to define a distinct subtype of AML with T-lymphoid features (CD2+ AML) and could reflect either aberrant gene expression in leukemic blasts or transformation of a pluripotent stem cell having a flexible pattern of gene expression. Clinically, these 10 patients presented at an older age with a higher leukocyte count and a higher frequency of lymphadenopathy than did children whose blast cells were characteristic of myeloid leukemia. Patients with CD2+ AML also had poorer responses to remission induction therapy (50% v 80% entered complete remission, P = .05). However, each of the five children who failed induction chemotherapy on AML protocols had a striking response to drug combinations usually reserved for lymphoid leukemia. We conclude that this leukemia with mixed lymphoid and myeloid characteristics is a distinct biologic and clinical entity. © 1988 by Grune & Stratton, Inc.