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Vol. 130, No. 3, 2013
Issue release date: September 2013
Acta Haematol 2013;130:188-191
(DOI:10.1159/000347165)

Precursor B-Cell Lymphoblastic Leukemia with Surface Immunoglobulin Light Chain Expression in 2 Chinese Patients

Liu Y. · Zhai Y. · Zhang Y. · Cheng W. · Li Y.
Hematology Department, Henan Provincial People's Hospital, The People's Hospital of Zhengzhou University, Zhengzhou, China

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Abstract

Background: Precursor B-cell acute lymphocytic leukemia (ALL) with surface immunoglobulin light chain expression is a rare disease entity. The differential diagnosis is difficult but critical for disease management. Aims: We report 2 cases (1 adult and 1 infant) of precursor B-cell ALL who presented at diagnosis with surface immunoglobulin light chain expression revealed by flow cytometric immunophenotyping and discuss its clinical significance. Case Report: The 2 patients presented with nonspecific symptoms such as fever, pallor, fatigue or lymphadenopathy. Flow cytometric immunophenotyping showed that both patients expressed CD34/CD19/CD10/CD22/CD9/HLA-DR/CD38/CD123/CD13 (partial) and had unexpected single λ light chain expression. Cytogenetic analysis revealed t(9;22)(q34;q11) in the adult patient and normal karyotype in the infant. Both cases were diagnosed and managed as precursor B-ALL, and the patients showed good response to treatment regimens. Conclusion: We describe 2 cases of precursor B-ALL with unexpected surface light chain expression. The exceedingly rare immunophenotypes have diagnostic implication for immunophenotyping of this malignancy. Treatment regimens for precursor B-cell ALL are suitable for such cases.



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References

  1. Jabbour EJ, Faderl S, Kantarjian HM: Adult acute lymphoblastic leukemia. Mayo Clin Proc 2005;80:1517-1527.
  2. Paolini S, Gazzola A, Sabattini E, Bacci F, Pileri S, Piccaluga PP: Pathobiology of acute lymphoblastic leukemia. Semin Diagn Pathol 2011;28:124-134.
  3. Hsi ED: The leukemias of mature lymphocytes. Hematol Oncol Clin North Am 2009;23:843-871.
  4. de Tute RM: Flow cytometry and its use in the diagnosis and management of mature lymphoid malignancies. Histopathology 2011;58:90-105.
  5. Behm FG, Head DR, Pui C-H, Rivera GR, Ribeiro RC, Raimondi SC: B-precursor ALL with unexpected expression of surface immunoglobulin (sIg) mu and lambda (abstract). Lab Invest 1995;72:106A.

    External Resources

  6. Michiels JJ, Adriaansen HJ, Hagemeijer A, Hooijkaas H, van Dongen JJ, Abels J: TdT positive B-cell acute lymphoblastic leukemia (B-ALL) without Burkitt characteristics. Br J Haematol 1988;68:423-426.
  7. Vasef MA, Brynes RK, Murata-Collins JL, Arber DA, Medeiros LJ: Surface immunoglobulin light chain-positive acute lymphoblastic leukemia of FAB L1 or L2 type: a report of 6 cases in adults. Am J Clin Pathol 1998;110:143-149.
  8. Kansal R, Deeb G, Barcos M, Wetzler M, Brecher ML, Block AW, Stewart CC: Precursor B lymphoblastic leukemia with surface light chain immunoglobulin restriction: a report of 15 patients. Am J Clin Pathol 2004;121:512-525.
  9. Li S, Lew G: Is B-lineage acute lymphoblastic leukemia with a mature phenotype and l1 morphology a precursor B-lymphoblastic leukemia/lymphoma or Burkitt leukemia/lymphoma? Arch Pathol Lab Med 2003;127:1340-1344.
  10. Chan NP, Ma ES, Wan TS, Chan LC: The spectrum of acute lymphoblastic leukemia with mature B-cell phenotype. Leuk Res 2003;27:231-234.
  11. Frater JL, Batanian JR, O'Connor DM, Grosso LE: Lymphoblastic leukemia with mature B-cell phenotype in infancy. J Pediatr Hematol Oncol 2004;26:672-677.
  12. Hammami A, Chan WC, Michels SD, Nassar VH: Mature B-cell acute leukemia: a clinical, morphological, immunological, and cytogenetic study of nine cases. Hematol Pathol 1991;5:109-118.
  13. Ohtsuki T, Ogawa Y, Izumi T, Hatake K, Miura Y: Two cases of mature B-cell acute lymphocytic leukemia with normal karyotype in adults. Acta Haematol 1996;96:258-261.


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