Heterogeneity of T cell lymphoblastic leukaemias

J Clin Pathol. 1991 Aug;44(8):628-31. doi: 10.1136/jcp.44.8.628.

Abstract

Twenty eight out of 170 consecutive cases of acute lymphoblastic leukaemia (ALL) were examined. They were of T cell origin, with the following distribution: seven (28%) cases had pre-T or prothymic features; nine (36%) cases showed early thymocytic features, six (24%) had cortical features; and three (12%) had a "mature" phenotype. The remaining three cases could not be sub-classified. A striking finding was that pre-T ALL differed from intrathymic ALL not only in the absence of both E rosettes and intrathymic differentiation antigens, but also in the expression of two non-lineage specific antigens HLA-DR and CD10. Both antigens appear in the bone marrow from the very first stages of lymphoid differentiation, implying that the origin for pre-T ALL is bone marrow. A comparison of the clinical features of pre-T and thymic ALL showed that pre-T ALL disease showed a pattern more similar to non-T ALL disease: a lower incidence of mediastinal mass, absence of extrahaematopoietic disease, lower white cell counts and haemoglobin concentrations, and a higher incidence of bone pain. No obvious difference in response to treatment was apparent. The results show that T-ALL is not only a heterogeneous immunological group but also suggest that it may have different origins: bone marrow for pre-T ALL and the thymus for thymic ALL.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antigens, CD / analysis
  • Antigens, Neoplasm / analysis
  • Cell Differentiation
  • Child
  • Child, Preschool
  • Female
  • Histocompatibility Antigens Class II / analysis
  • Humans
  • Leukemia-Lymphoma, Adult T-Cell / immunology*
  • Leukemia-Lymphoma, Adult T-Cell / mortality
  • Leukemia-Lymphoma, Adult T-Cell / pathology
  • Male
  • Middle Aged
  • Sex Factors

Substances

  • Antigens, CD
  • Antigens, Neoplasm
  • Histocompatibility Antigens Class II