B-Acute Lymphoblastic Leukemia/Lymphoblastic Lymphoma

Loghavi, Sanam MD
Kutok, Jeffery L. MD, PhD
Jorgensen, Jeffrey L. MD, PhD

¹Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston; and
²Infinity Pharmaceuticals, Cambridge, MA.

Corresponding author: Jeffrey L. Jorgensen, MD, PhD, Dept of Hematopathology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030; [email protected].

American Journal of Clinical Pathology 144(3):p 393-410, September 01, 2015. | DOI: 10.1309/AJCPAN7BH5DNYWZB

Objectives

This session of the 2013 Society of Hematopathology/European Association for Haematopathology Workshop was dedicated to B-acute lymphoblastic leukemia (B-ALL)/lymphoblastic lymphoma (LBL) with recurrent translocations and not otherwise specified.

Methods

In this review, we summarize the cases discussed during the workshop, review the pertinent and most recent literature on the respective topics, and provide a few key points that may aid in the workup of patients with B-ALL/LBL.

Results

Many of the submitted cases showed interesting diagnostic, immunophenotypic, or clinical aspects of B-ALL with BCR/ABL1, MLL-associated, and other recurrent chromosomal abnormalities. Several cases showed rare aberrancies such as coexistent IGH/BCL2 and MYC rearrangements and raised issues in classification. Other cases had unusual clinical presentations, including B-ALL with hypereosinophilia and therapy-related B-ALL. Several cases highlighted the role of flow cytometry immunophenotyping in distinguishing benign B-cell precursors from aberrant lymphoblasts, and other cases raised questions regarding the clinical importance of myeloperoxidase positivity in acute lymphoblastic leukemia.

Conclusions

The complexity and spectrum of cases presented in this review highlight the importance of clinicopathologic correlation and the value of ancillary studies in the classification and workup of patients with B-ALL/LBL.