TCL-1-positive hematogones in a patient with T-cell prolymphocytic leukemia after therapy.
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.
['Hu|Zhihong|Z|', 'Li|Shaoying|S|', 'Medeiros|L Jeffrey|LJ|', 'Sun|Tsieh|T|']
D000074323:Alemtuzumab D061067:Antibodies, Monoclonal, Humanized D000970:Antineoplastic Agents D014408:Biomarkers, Tumor D001706:Biopsy D001854:Bone Marrow Cells D001856:Bone Marrow Examination D003937:Diagnosis, Differential D006801:Humans D007150:Immunohistochemistry D007621:Karyotyping D015461:Leukemia, Prolymphocytic, T-Cell D008297:Male D008875:Middle Aged D011237:Predictive Value of Tests D011518:Proto-Oncogene Proteins D012074:Remission Induction D033581:Stem Cell Transplantation D016896:Treatment Outcome
Hematogone T-prolymphocytic leukemia TCL-1 Follow-up Bone marrow Flow cytometry Lymphocytosis