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B-acute lymphoblastic leukemia/lymphoblastic lymphoma.

Sanam Loghavi1, Jeffery L Kutok2, Jeffrey L Jorgensen3

  • 1From the Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston; and.

American Journal of Clinical Pathology
|August 16, 2015
PubMed
Summary

This review covers B-acute lymphoblastic leukemia (B-ALL) and lymphoblastic lymphoma (LBL) cases with recurrent translocations. It emphasizes clinicopathologic correlation and ancillary studies for accurate diagnosis and patient workup.

Keywords:
B-ALLCytogeneticsFlow cytometry immunophenotypingMyeloid

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Area of Science:

  • Hematopathology
  • Molecular Genetics
  • Clinical Oncology

Background:

  • The 2013 Society of Hematopathology/European Association for Haematopathology Workshop focused on B-acute lymphoblastic leukemia (B-ALL) and lymphoblastic lymphoma (LBL).
  • This session specifically addressed B-ALL/LBL with recurrent translocations and cases not otherwise specified.

Purpose of the Study:

  • To summarize cases discussed at the workshop.
  • To review recent literature on B-ALL/LBL with recurrent translocations.
  • To provide key insights for the diagnostic workup of B-ALL/LBL patients.

Main Methods:

  • Review of submitted cases from the workshop.
  • Comprehensive literature review of pertinent and recent studies.
  • Analysis of diagnostic, immunophenotypic, and clinical aspects.

Main Results:

  • Cases presented diverse features, including BCR/ABL1 and MLL-associated abnormalities.
  • Rare genetic aberrations like IGH/BCL2 and MYC rearrangements were observed, posing classification challenges.
  • Unusual clinical presentations, such as hypereosinophilia and therapy-related B-ALL, were noted.
  • Flow cytometry's role in differentiating lymphoblasts from B-cell precursors was highlighted.
  • The clinical significance of myeloperoxidase positivity in B-ALL was questioned.

Conclusions:

  • The wide spectrum of B-ALL/LBL cases underscores the need for integrated clinicopathologic correlation.
  • Ancillary studies, including genetic and immunophenotypic analyses, are crucial for accurate classification and patient management.
  • Effective workup of B-ALL/LBL requires a multidisciplinary approach considering complex genetic and clinical factors.