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The Flow Cytometric Evaluation of B- and T-Lymphoblastic Leukemia/Lymphoma
1Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.
Insights
This review details flow cytometry findings for diagnosing lymphoblastic leukemia/lymphoma. It highlights key markers like CD45, TdT, and CD34 for identifying B- and T-cell neoplasms.
Area of Science:
- Hematology
- Oncology
- Immunology
Background:
- Lymphoblastic leukemia/lymphoma (LBL) is a cancer of immature lymphoid cells.
- It typically affects bone marrow and blood but can involve lymph nodes and other tissues.
- Accurate diagnosis relies on morphology, immunophenotyping, and genetic analysis.
Purpose of the Study:
- To review the flow cytometric immunophenotypic features of B- and T-lymphoblastic leukemia/lymphoma.
- To emphasize characteristic marker expressions used in diagnosis.
Main Methods:
- Focus on flow cytometry for immunophenotypic analysis.
- Discussion of specific marker expressions in B- and T-LBL.
Main Results:
- Key findings include expression of early B or T cell markers.
- Low-level expression of CD45 is noted.
- Expression of terminal deoxynucleotidyl transferase (TdT) and CD34 are frequently observed.
Conclusions:
- Flow cytometry provides crucial immunophenotypic data for diagnosing LBL.
- Specific marker profiles aid in distinguishing B- and T-lineage LBL.
Abstract:
Lymphoblastic leukemia/lymphoma, a neoplasm of precursor B or T lineage lymphoid cells, usually involves the bone marrow and peripheral blood, and may involve nodal and/or extranodal sites. The diagnosis is based on morphologic assessment, immunophenotypic analysis, usually by flow cytometry, and genetic analysis, including cytogenetics and FISH analysis, as well as molecular diagnostic analysis. This review will focus on the flow cytometric immunophenotypic findings in B- and T-lymphoblastic leukemia/lymphoma, which include expressions of early B or T cell markers, low-level expressions of CD45, as well as expressions of terminal deoxynucleotidyl transferase (TdT), and, in many cases, stem/progenitor cell marker CD34.
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