What are the distinctions of cytogenetic abnormalities in acute lymphoblastic leukemia (ALL)?

Updated: Jul 17, 2018
  • Author: Karen Seiter, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

Eighty-five percent of cases of ALL are derived from B cells. The primary distinction is among the following (see also Table 3, below):

  • Early (pro-B) ALL, which is TDT positive, CD10 (CALLA) negative, surface immunoglobulin (Ig) negative

  • Precursor B ALL, which is TDT positive, CD10 (CALLA) positive, surface Ig negative

  • Mature B cell (Burkitt) ALL, which is TdT negative, surface Ig positive. Fifteen percent of these cases are derived from T cells.

Table 3. Immunophenotyping of ALL Cells – ALL of B-Cell Lineage (85% of cases of adult ALL) (Open Table in a new window)

ALL Cells

TdT

CD19

CD10

CyIg

SIg

Early B-precursor ALL

+

+

-

-

-

Pre–B-cell ALL

+

+

+

+

-

B-cell ALL

-

+

+/-

+/-

+

ALL = acute lymphoblastic leukemia; Cylg = Cytoplasmic immunoglobulin; SIg =Surface immunoglobulin; TdT = terminal deoxynucleotidyl transferase.

These cases are subclassified into different stages corresponding to the phases of normal thymocyte development. The early subtype is surface CD3 negative, cytoplasmic CD3 positive, and either double negative (CD4-, CD8-) or double positive (CD4+, CD8+). The latter subtype is surface CD3 positive, CD1a negative, and positive for either CD4 or CD8, but not both. See Table 4, below.

Table 4. Immunophenotyping of ALL Cells – ALL of T-Cell Lineage (15% of cases of adult ALL) (Open Table in a new window)

ALL Cells

TdT

Surface CD3

CD4/CD8

Early T-precursor ALL

+

-

+/+ or -/-

T-cell ALL

+

+

+/- or -/+


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