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<p>T-cell acute lymphoblastic leukemia (T-ALL) is characterized by distinct immunophenotypic subtypes and variable treatment response. There is limited data on the frequency and clinical relevance of aberrant antigen expression patterns across large T-ALL cohorts, particularly in relation to MRD outcomes. We studied antigen expression in 149 newly diagnosed T-ALL cases using multicolour flow cytometry. Cases were classified as early T-cell precursor (ETP), near-ETP, or non-ETP phenotypes, with non-ETP cases further subclassified into pro–T, pre–T, cortical, and mature T-ALL. Aberrant antigen expression patterns, including myeloid and NK-associated markers, were documented. MRD analysis by flow cytometry was performed at post-induction with a sensitivity of 0.001%. Of 149 patients, 90 (60.4%) were &lt; 18 years (mean 9.5 years) and 59 (39.6%) were ≥ 18 years (mean 41.1 years); the male-to-female ratio was 3.1:1. The distribution of immunophenotypes was: ETP-ALL (<i>n</i> = 33, 22%), near-ETP-ALL (<i>n</i> = 17, 11%), and non-ETP-ALL (<i>n</i> = 99, 67%) — including pre–T (<i>n</i> = 31), cortical T (<i>n</i> = 61), and mature T-ALL (<i>n</i> = 7). Aberrant myeloid antigen expression was observed in 47% of cases, most commonly CD33, CD13, and CD117. CD73 and CD11b expression were consistently associated with MRD positivity at the end of induction. ETP-ALL was more frequent in adults and showed higher co-expression of myeloid markers and poorer MRD clearance compared to non-ETP subtypes. This large single-centre study demonstrates distinct antigenic profiles across T-ALL subtypes. CD73 and CD11b positivity were strongly associated with persistent MRD, underscoring their potential role as prognostic markers.</p>

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Study of Antigen Expression in T-cell Acute Lymphoblastic Leukaemia by Multiparametric Flow Cytometry: Expression of CD73 and CD11b is Associated with MRD Positivity and May Suggest a Poor-risk Phenotype

  • 期刊论文

  • 发表日期：

    2026年1月7日

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  • Thulasi Raman Ramalingam,
  • Dheenadayalan Rajendiran,
  • Mamta Soni,
  • Jose Easow,
  • Thirumalairaj Raja,
  • Revathi Raj

摘要

T-cell acute lymphoblastic leukemia (T-ALL) is characterized by distinct immunophenotypic subtypes and variable treatment response. There is limited data on the frequency and clinical relevance of aberrant antigen expression patterns across large T-ALL cohorts, particularly in relation to MRD outcomes. We studied antigen expression in 149 newly diagnosed T-ALL cases using multicolour flow cytometry. Cases were classified as early T-cell precursor (ETP), near-ETP, or non-ETP phenotypes, with non-ETP cases further subclassified into pro–T, pre–T, cortical, and mature T-ALL. Aberrant antigen expression patterns, including myeloid and NK-associated markers, were documented. MRD analysis by flow cytometry was performed at post-induction with a sensitivity of 0.001%. Of 149 patients, 90 (60.4%) were < 18 years (mean 9.5 years) and 59 (39.6%) were ≥ 18 years (mean 41.1 years); the male-to-female ratio was 3.1:1. The distribution of immunophenotypes was: ETP-ALL (n = 33, 22%), near-ETP-ALL (n = 17, 11%), and non-ETP-ALL (n = 99, 67%) — including pre–T (n = 31), cortical T (n = 61), and mature T-ALL (n = 7). Aberrant myeloid antigen expression was observed in 47% of cases, most commonly CD33, CD13, and CD117. CD73 and CD11b expression were consistently associated with MRD positivity at the end of induction. ETP-ALL was more frequent in adults and showed higher co-expression of myeloid markers and poorer MRD clearance compared to non-ETP subtypes. This large single-centre study demonstrates distinct antigenic profiles across T-ALL subtypes. CD73 and CD11b positivity were strongly associated with persistent MRD, underscoring their potential role as prognostic markers.