title: Your dilemma, my identity: unusual immunogenetic profiles of pediatric B cell acute lymphoblastic leukemia.
abstract: B-cell acute lymphoblastic leukemia (B-ALL) is characterized by CD19 expression, which is one of the most important prerequisites, along with expression of CD10, CD22 and/or CD79a. Rearrangements involving MLL gene are seen in CD10- B-ALL (pro-B cell origin) and t(9;11)(p21;q23) is most commonly reported in acute myeloid leukemia (AML), where it is known to carry very good prognosis in pediatric AMLs and rarely in acute lymphoblastic leukemia (ALL). We report a case of CD10+, CD19- pediatric ALL with rearrangements of MLL gene as a result of t(9;11)(p21;q23), thus conferring a very poor prognosis. The case emphasizes use of comprehensive panel of antibodies for flow cytometric immunophenotyping and cytogenetic correlation for correct diagnosis and prognostication.
authors.forename: Anurag
authors.initials: A
authors.lastname: Gupta
authors.affiliation: Department of Hematopathology, AmPath, American Oncology Institute and Citizens Hospital, Hyderabad, Andhra Pradesh, India.
authors.forename: Manu
authors.initials: M
authors.lastname: Goyal
authors.forename: Koteswara Rao
authors.initials: KR
authors.lastname: Nidamanuri
authors.forename: Palanki Satya
authors.initials: PS
authors.lastname: Dattatreya
mesh_terms: D018941:Antigens, CD19 / Q000032:analysis; D001402:B-Lymphocytes / Q000737:chemistry*; D002675:Child, Preschool; D005260:Female; D005434:Flow Cytometry; D015321:Gene Rearrangement; D011495:Histone-Lysine N-Methyltransferase; D006801:Humans; D016130:Immunophenotyping; D015448:Leukemia, B-Cell / Q000175:diagnosis* / Q000235:genetics*; D051788:Myeloid-Lymphoid Leukemia Protein / Q000235:genetics*; D015260:Neprilysin / Q000032:analysis; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000175:diagnosis* / Q000235:genetics*
chemical_list: D018941:Antigens, CD19; C497422:KMT2A protein, human; D051788:Myeloid-Lymphoid Leukemia Protein; D011495:Histone-Lysine N-Methyltransferase; D015260:Neprilysin