title: TCL-1-positive hematogones in a patient with T-cell prolymphocytic leukemia after therapy.
abstract: 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.
authors.affiliation: Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030.
authors.forename: Zhihong
authors.initials: Z
authors.lastname: Hu
authors.affiliation: Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030.
authors.forename: Shaoying
authors.initials: S
authors.lastname: Li
authors.affiliation: Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030.
authors.forename: L Jeffrey
authors.initials: LJ
authors.lastname: Medeiros
authors.affiliation: Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030. Electronic address: tsun5@mdanderson.org.
authors.forename: Tsieh
authors.initials: T
authors.lastname: Sun
mesh_terms: D000074323:Alemtuzumab; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000235:genetics / Q000378:metabolism*; D001706:Biopsy; D001854:Bone Marrow Cells / Q000187:drug effects / Q000378:metabolism*; D001856:Bone Marrow Examination; D003937:Diagnosis, Differential; D006801:Humans; D007150:Immunohistochemistry; D007621:Karyotyping; D015461:Leukemia, Prolymphocytic, T-Cell / Q000235:genetics / Q000378:metabolism* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011518:Proto-Oncogene Proteins / Q000235:genetics / Q000378:metabolism*; D012074:Remission Induction; D033581:Stem Cell Transplantation; D016896:Treatment Outcome
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D011518:Proto-Oncogene Proteins; C090851:TCL1A protein, human; D000074323:Alemtuzumab
keywords: Bone marrow; Flow cytometry; Follow-up; Hematogone; Lymphocytosis; T-prolymphocytic leukemia; TCL-1