NOTE

🌱 created from: diagnosis_of_all

work_in_adult_all

• start diagnostic workup for adult acute lymphoblastic leukemia Morphology

• specifically:

  • Morphology
    • Defines infiltration (>25% required for a diagnosis of ALL vs lymphoblastic lymphoma)
    • recngnize L3 (Burkitt-type) subsets
  • Multicolor Flow cytometry (MFC)
    • B-lineage ALL (B-LIN): CD19, cCD79a, c/sCD22 (minimal requirement), TdT, CD10, CD20, cIgM, sIg (kappa or lambda)
    • EGIL classification
      • Pro-B: CD19/CD79a/cCD22+/CD10– (B-I), NG2
      • Common: CD10+/cIgM– (B-II)
      • Pre-B: cIgM+/sIg– (B-III)
    • T-lineage ALL∗: c/sCD3, CD7 (minimal requirement), TdT, CD1a, CD2, CD5, CD4, CD8, TCR α/β or γ/δ
      • Pro-T: cCD3/CD7+ (T-I)
      • Pre-T: CD2/CD5+ (T-II)
      • Cortical-T: CD1a+ (T-III)
      • Mature-T: sCD3+/CD1a– (T-IV)
  • MPO: r/o AML
  • Molecular genetics
    • t(9;22)/Ph+/BCR::ABL1
    • t(4;11)+/KMT2Ar
    • t(1;19)+/TCF3::PBX1
    • Other high-risk cytogenetics
  • MRD (molecular or MFC)
  • consider extended genomics: NGS