Acute Lymphoblastic Leukemia With Surface Light Chain Expression
Abstract
Acute Lymphoblastic leukemias (ALL) are a heterogeneous group of neoplasms which can either be having precursor B cell immunophenotype or mature B cell immunophenotype. Surface immunoglobulin light chain restriction is usually a feature of mature B cell neoplasms. A precursor B cell lymphoblastic leukemia (pre-B-ALL) with surface immunoglobulin light chain expression is a rare immunophenotype . We report a case of a 4 year old female with L1 type of blast morphology yet showing surface light chain restriction. Recognizing this rare immunophenotype and arriving at a correct diagnosis has therapeutic implications as treatment regimens differ for precursor B ALL as compared to mature B cell neoplasms.References
Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pilleri SA, et al. WHO Classification of Tumours of Hematopoietic and Lymphoid Tissues. Lyon: IARC; 2017 Revised edition.
Vasef MA, Brynes RK, Murata-Collins JL, et al. 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;110:143-9.
Liu Y, et al. Precursor B cell Lymphoblastic Leukemia with surface immunoglobulin Light chain expression in two Chinese patients. Acta Hematol. 2013;130:188-91.
Kansal R, Deeb G, Barcos M, Wetzler M, Brecher ML, Block AW, et al. Precursor B lymphoblastic leukemia with surface light chain immunoglobulin restriction: A report of 15 patients. Am J Clin Pathol. 2004;121:512-25.
Rabade N, Bibi A, Ghodke K, Patkar N, Tembhare P, Amare P, et al. Lymphoblastic leukemia with surface light chain restriction: A diagnostic dilemma. Indian J Pathol Microbiol. 2016;59:410-2.
Li S. Is B linage 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.
Sullivan MP, Pullen DJ, Crist WM, et al. Clinical and biological heterogeneity of childhood B cell acute lymphocytic leukemia: implications for clinical trials. Leukemia. 1990;4:6-11.
Sullivan MP, Crist W, Pullen J, et al. Childhood B cell ALL is unexpectedly clinically heterogeneous: A Pediatric Oncology Study (POG) study. Proc Soc Clin Oncol. 1987;6:148A.
Van Eys J, Pullen J, Head D, et al. The French –American-British (FAB) classification of leukemia: The Pediatric Oncology Group experience with lymphocytic leukemia. Cancer. 1986;57:1046-51.
Behm FG, Head DR, Pui CH, et al. B cell precursor ALL with unexpected expression of surface immunoglobulin (sIg) Mu and lambda. Lab Invest. 1995;72:106A.
Finlay JL, Borcherding W. Acute Lymphoblastic leukemia with L1 morphology: A report of two pediatric cases. Leukemia. 1988;2:60-2.
Hurwitz C, Loken MR, Graham ML, et al. Asynchronous antigen expression in B lineage acute lymphoblastic leukemia. Blood. 1998;72:299-307.
Michelis JJ, Adriaansen HJ, Hagemeijer A, et al. TdT positive B cell acute lymphoblastic leukemia( B-ALL) without Burkitt characteristics. Br J Hematol. 1988;68:423-6.
Shende A, Festa RS, Wedgewood JF, Lanzkowsky P. A pediatric case of TdT positive B cell acute lymphoblastic leukemia ( B-ALL) without Burkitt characteristics. Br J Hematol. 1988;70:129-30.
Navid F, Mosijczuk AD, Head DR, et al. Acute lymphoblastic leukemia with t(8:14) (q24:q23) translocation and FAB L3 morphology associated with precursor immunophenotype: The pediatric Oncology Group experience. Leukemia. 1999;13:135-41.
Copyright (c) 2023 Kalyani Bapat, Dia Mansukhani, Shanaz Khodaiji, Sachin Almel
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access at http://opcit.eprints.org/oacitation-biblio.html).
