Acute myeloid leukemia with T-lymphoid features: A distinct biologic and clinical entity

A. H. Cross, R. M. Goorha, R. Nuss, F. G. Behm, S. B. Murphy, D. K. Kalwinsky, S. Raimondi, G. R. Kitchingman, J. Mirro

Research output: Contribution to journalArticlepeer-review

158 Scopus citations


We studied the clinical and biologic features of 10 cases of acute leukemia that met standard French-American-British (FAB) criteria for acute myeloid leukemia (AML) but in which the blast cells also expressed the T-cell-associated CD2 surface antigen. All cases had >3% myeloperoxidase and Sudan black B-positive leukemic blasts, and blasts from seven cases contained Auer rods. Reactivity of the cells with a panel of monoclonal antibodies (MAbs) indicated that leukemic cells in all cases expressed myeloid-associated (CD11b, CD13) surface antigens, further supporting the diagnosis of AML. However, blasts from every patient coexpressed the T-cell-associated surface CD2 and CD7 as well as cytoplasmic CD3 antigens. Blasts from five patients expressed surface CD25, whereas blasts from only one expressed surface CD3. Five patients had rearranged T-cell receptor β-chain genes, whereas only three had rearranged T-cell receptor γ-chain genes. This pattern of lineage-related gene expression appears to define a distinct subtype of AML with T-lymphoid features (CD2+ AML) and could reflect either aberrant gene expression in leukemic blasts or transformation of a pluripotent stem cell having a flexible pattern of gene expression. Clinically, these 10 patients presented at an older age with a higher leukocyte count and a higher frequency of lymphadenopathy than did children whose blast cells were characteristic of myeloid leukemia. Patients with CD2+ AML also had poorer responses to remission induction therapy (50% v 80% entered complete remission, P = .05). However, each of the five children who failed induction chemotherapy on AML protocols had a striking response to drug combinations usually reserved for lymphoid leukemia. We conclude that this leukemia with mixed lymphoid and myeloid characteristics is a distinct biologic and clinical entity.

Original languageEnglish
Pages (from-to)579-587
Number of pages9
Issue number2
StatePublished - 1988


Dive into the research topics of 'Acute myeloid leukemia with T-lymphoid features: A distinct biologic and clinical entity'. Together they form a unique fingerprint.

Cite this