Distinct immunophenotype of early T-cell progenitors in T lymphoblastic leukemia/lymphoma may predict FMS-like tyrosine kinase 3 mutations

Charles M. Zaremba, Dwight Oliver, Maryellen Cavalier, Franklin Fuda, Nitin J. Karandikar, Weina Chen

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

FMS-like tyrosine kinase 3 (FLT3) mutation in T lymphoblastic leukemia/lymphoma (T-LL) is rare (∼4%) and reported only in cases with CD117 expression. This study aimed to identify the immunophenotypic features that may predict FLT3 mutations. We report 3 (43%) of 7 CD117 + T-LL cases harboring FLT3-internal tandem duplication mutation. Compared with 4 FLT3-unmutated cases, all 3 FLT3-mutated cases had a distinct immunophenotype (CD1a -/CD2 +/CD7 +/CD34 +/CD117 uniform+/Tdt +) corresponding to the stage of earliest thymic T-cell progenitors possessing myeloid lineage potential. Indeed, all FLT3-mutated T-LL cases expressed myeloperoxidase on a very small subset of blasts and, thus, may be further considered a mixed phenotype acute leukemia, T/myeloid, by the 2008 World Health Organization classification scheme. We conclude that this unique immunophenotype (CD1a -/CD2 +/CD7 +/CD34 +/CD117 +/Tdt +) is a better predictor of FLT3 mutation than sole CD117 expression.

Original languageEnglish (US)
Pages (from-to)16-20
Number of pages5
JournalAnnals of Diagnostic Pathology
Volume16
Issue number1
DOIs
StatePublished - Jan 1 2012

Keywords

  • Biphenotypic leukemia
  • CD117
  • FLT3 mutation
  • Immunophenotype
  • T lymphoblastic leukemia

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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