Childhood T-cell acute lymphoblastic leukaemia expressing “Ia-like” antigen: A case report

✍ Scribed by Kupa, Ann ;Beckman, Ian G. R. ;Bradley, John ;Moore, Helen ;Thomas, Miriam ;Zola, Heddy ;Cheney, Kevin ;Rice, Michael ;Toogood, Ian

• Publisher: John Wiley and Sons
• Year: 1982
• Tongue: English
• Weight: 573 KB
• Volume: 10
• Category: Article
• ISSN: 0098-1532
• DOI: 10.1002/mpo.2950100406

✦ Synopsis

Abstract

A 4‐year‐old girl presenting with vomiting, abdominal pain, and renal failure was found to have gross hepatosplenomegaly, a renal mass, and bilateral pleural effusions. A diagnosis of acute lymphoblastic leukaemia (ALL) was suggested by a peripheral white cell count (WCC) of 119,000 × 10^6^/mm^3^, 57% blasts, 22% lymphocytes, and confirmed by bone marrow examination. Lymphocyte surface marker studies at diagnosis enabled classification as a T‐ALL, with a significant proportion of the T cells also bearing receptors for the third component of complement (C3). Seventy‐two percent of the peripheral blood mononuclear cells reacted with anti‐Ia monoclonal antibody (FMC 4), and a smaller proportion (25%) carried receptors for the Fc portion of IgG.

The T‐classification of this ALL was verified at central nervous system (CNS) relapse and at a subsequent nodal relapse. Double‐marker studies on cells from the infiltrated lymph node prepared in suspension confirmed the presence of Ia‐positive T cells. The Ia marker is usually a useful discriminant between T and non‐T cells in normal and ALL cell populations. The case described here highlights the need for a panel of markers to be used in classification of childhood ALL and supports the suggestion that there is a distinct subtype of Ia‐positive T‐ALL.