The Immunophenotype of pre‐T ALL Revisited

The WHO suggested immunophenotype for pre‐T ALL includes the expression of TdT, cCD3, and CD7, while CD2, CD3, CD4, CD5, CD8, and CD10 are variably expressed. The myeloid antigens CD13 and CD33 are usually positive, whereas CD117 and cCD79a are infrequently expressed. There is frequent dual expression of CD4/ CD8. In our study, 15 of 19 cases were evaluated for TdT, cCD3, and cCD79a expression. Eleven (73.3%) positively expressed TdT, 15 (100%) positively expressed cCD3, and 9 (60%) were positive for cCD79a. Of 17 cases analyzed for CD7, CD5, and CD10, CD7 and CD5 were positive in all 17 cases, whereas CD10 was positive in 8 (47.1%) cases. Of the 18 cases evaluated for CD2, CD3, CD4, CD8, and dual expression of CD4/ CD8, CD2 was expressed in 14 (77.8%), while CD3 was expressed in 7 (38.9%) cases. CD4 was positive in 11 (61.1%), and CD8 was expressed in 9 (50%). Dual expression of CD4/CD8 occurred in 4 (22.2%) of the cases. Of the 16 analyzed for CD13, CD33, and CD117, 1 case (6.3%) expressed CD13, while 2 (12.5%) cases expressed CD33 and CD117. Thus, these data point to the need for a more extensive study to reevaluate the current WHO defined immunophenotype used in the diagnosis of pre‐TALL.