Related Experiment Video
Updated: Aug 6, 2026
Identification of Quiescent Cells in a Zebrafish T-Cell Acute Lymphoblastic Leukemia Model Using Cell Proliferation Staining
Published on: July 19, 2024
The immunophenotype of pre-TALL/LBL revisited
Robert E Lewis1, Julius M Cruse, Catherine M Sanders
1Department of Pathology, University of Mississippi Medical Center, 2500 North State Street, Jackson, Mississippi 39216, USA.
Insights
Flow cytometry for cluster of differentiation (CD) markers aids in diagnosing T cell acute lymphoblastic leukemia (T-ALL)/lymphoblastic lymphoma (LBL). This study suggests reevaluating the World Health Organization
Area of Science:
- Hematology
- Immunology
- Oncology
Background:
- Flow cytometric analysis of cluster of differentiation (CD) markers is essential for diagnosing precursor T cell acute lymphoblastic leukemia (T-ALL)/lymphoblastic lymphoma (LBL).
- The World Health Organization (WHO) provides guidelines for the immunophenotype of pre-T ALL/LBL, including typical marker expressions and variations.
Purpose of the Study:
- To analyze the expression of selected CD markers in 19 cases of pre-T ALL/LBL.
- To evaluate the current WHO-defined immunophenotype for pre-T ALL/LBL based on observed marker expression patterns.
Main Methods:
- Flow cytometric analysis was performed on 19 cases of pre-T ALL/LBL.
- Expression levels of various CD markers including TdT, cCD3, CD7, CD2, CD3, CD4, CD5, CD8, CD10, CD13, CD33, CD117, and cCD79a were assessed.
Main Results:
- High positivity rates were observed for TdT (73.3%), cCD3 (100%), CD7 (100%), and CD5 (100%).
- Variable expression was noted for CD2 (77.8%), CD3 (38.9%), CD4 (61.1%), CD8 (50%), and CD10 (47.1%).
- Myeloid antigen expression (CD13, CD33, CD117) and dual CD4/CD8 expression were infrequent, contrary to typical expectations.
Conclusions:
- The study findings indicate discrepancies between observed CD marker expression and the current WHO-defined immunophenotype for pre-T ALL/LBL.
- Further extensive research is needed to reevaluate and potentially revise the diagnostic immunophenotype criteria for pre-T ALL/LBL.
Abstract:
Flow cytometric analysis of cluster of differentiation (CD) markers in abnormal lymphocyte populations is crucial in the diagnosis of precursor T cell acute lymphoblastic leukemia (T-ALL)/lymphoblastic lymphoma (LBL). The World Health Organization (WHO) suggested immunophenotype for pre-T ALL/LBL typically includes the expression of TdT, cCD3, and CD7, while CD2, CD3, CD4, CD5, CD8, and CD10 are variably expressed. The myeloid antigens CD13 and CD33 are usually positive, whereas CD117 and cCD79a are infrequently expressed. Furthermore, there is frequent dual expression of CD4 and CD8. In the present investigation, 19 cases of pre-TALL/LBL were analyzed for selected CD marker expression. Fifteen of 19 cases studied were evaluated for TdT, cCD3, and cCD79a expression. Eleven (73.3%) positively expressed TdT, 15 (100%) positively expressed cCD3, and 9 (60%) positively expressed cCD79a. Of the 17 cases analyzed for CD7, CD5, and CD10 expression, CD7 and CD5 were positive in all 17 (100%) cases, whereas CD10 was positive in 8 (47.1%) cases. Of the 18 cases evaluated for CD2, CD3, CD4, CD8, and dual expression of CD4 and CD8, CD2 was expressed in 14 (77.8%), while CD3 was expressed in 7 (38.9%) cases. CD4 was positive in 11 (61.1%), and CD8 was expressed in 9 (50%). Dual expression of CD4 and CD8 occurred in only 4 (22.2%) of the cases. Of the 16 analyzed for CD13, CD33, and CD117, only 1 case (6.3%) expressed CD13, while 2 (12.5%) cases expressed CD33 and CD117. Thus, these data point to the need for a more extensive study to reevaluate the current WHO defined immunophenotype used in the diagnosis of pre-TALL/LBL.
