TCL-1-positive hematogones in a patient with T-cell prolymphocytic leukemia after therapy.

Abstract

T-prolymphocytic leukemia (T-PLL) is a rare mature T-cell neoplasm characterized by proliferation of prolymphocytes. Most cases involve the T-cell leukemia-1 (TCL1) gene at 14q11.2 resulting in overexpression of TCL-1, which is helpful for distinguishing T-PLL from other T-cell neoplasms. We report a patient with T-PLL whose leukemic cells were positive for TCL-1 by immunohistochemistry but with a normal karyotype. The patient had anti-CD52 antibody therapy for 12 weeks. In a follow-up bone marrow biopsy specimen, numerous TCL-1-positive cells were present, which raised the differential diagnosis of residual T-PLL. However, further immunophenotypic studies confirmed that these cells were hematogones. Therefore a diagnosis of recovering bone marrow was established. The patient underwent stem cell transplant and is now in complete remission. This case demonstrates that hematogones can express TCL-1, and this knowledge is very important for the differential diagnosis in the follow-up marrow of T-PLL patients.

• Authors: Zhihong Hu, Shaoying Li, L Jeffrey Medeiros, Tsieh Sun
• Journal: Human pathology (Hum Pathol) Vol. 65 Pg. 175-179 (07 2017) ISSN: 1532-8392 [Electronic] United States
• PMID: 28232160 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2017 Elsevier Inc. All rights reserved.

Chemical References

• Antibodies, Monoclonal, Humanized
• Antineoplastic Agents
• Biomarkers, Tumor
• Proto-Oncogene Proteins
• TCL1A protein, human
• Alemtuzumab

Topics

• Alemtuzumab
• Antibodies, Monoclonal, Humanized (therapeutic use)
• Antineoplastic Agents (therapeutic use)
• Biomarkers, Tumor (genetics, metabolism)
• Biopsy
• Bone Marrow Cells (drug effects, metabolism)
• Bone Marrow Examination
• Diagnosis, Differential
• Humans
• Immunohistochemistry
• Karyotyping
• Leukemia, Prolymphocytic, T-Cell (genetics, metabolism, therapy)
• Male
• Middle Aged
• Predictive Value of Tests
• Proto-Oncogene Proteins (genetics, metabolism)
• Remission Induction
• Stem Cell Transplantation
• Treatment Outcome