Acute leukemia of hybrid phenotype: T lymphoid and myelomonocytic markers

Several unique phenotypical and functional characteristics were found together in a patient with acute poorly differentiated leukemia. The blast cells showed an unusual T-cell phenotype, forming spontaneous rosettes with sheep red blood cells and expressing the T11 antigen, but were negative for the other immature or mature T markers tested--Leu-1, 3A1, T3, T4, T8, T9, T10, T6, and TdT--and reacted with the monoclonal antibody OKM1 expressed by myeloid lineage cells and which is also present in natural killer (NK) cells. Furthermore, these cells were able to produce interleukin-2 (IL-2) after mitogenic stimulation and showed cytotoxic activity against K-562 target cells after incubation with an IL-2 supernatant. These features do not correspond to any known stage of the T-cell differentiation pathway and may represent the expansion of a pre-NK cell which may be poorly represented in normal tissues.