CD7+, CD4-, CD8- acute leukemia: a syndrome of malignant pluripotent
lymphohematopoietic cells
J Kurtzberg, TA Waldmann, MP Davey, SH Bigner, JO Moore, MS Hershfield and BF Haynes
Department of Pediatrics, Duke University Medical Center, Durham, NC 27710.
Following our initial observation of in vivo conversion of CD7+, CD4-, CD8-
acute lymphoblastic leukemia (ALL) cells from lymphoid to myeloid lineages
(Proc Natl Acad Sci (USA) 81:253, 1984) we have studied eight additional
cases of ALL with this leukemic cell phenotype. The CD7+, CD4-, CD8-
phenotype was associated with a distinct clinical entity with those
affected predominantly male (either less than 35 years or greater than 65
years of age), with frequent mediastinal and/or thymic masses, skin and CNS
disease, high peripheral WBC counts, and bone marrow blasts that were
morphologically L1 or not ascribable to a specific lineage. These patients
did not respond to conventional chemotherapeutic regimens for either acute
lymphoid or myeloid leukemias. No common karyotype or T-cell gene
rearrangement pattern could be defined. Importantly, seven of eight
patient's leukemic cells studied were capable of multilineage (myeloid,
erythroid, monocytoid, megakaryocytoid, and lymphoid) differentiation in
vitro. Data is presented suggesting that CD7+, CD4-, CD8- leukemias, in
many instances, are leukemias of immature hematopoietic cells. The
development of novel therapeutic approaches to this form of leukemia will
be necessary to alter its poor prognosis.
Volume 73,
Issue 2,
pp. 381-390,
02/01/1989
Copyright © 1989 by The American Society of Hematology
