Asynchronous antigen expression in B lineage acute lymphoblastic leukemia

C. A. Hurwitz, M. R. Loken, M. L. Graham, J. E. Karp, M. J. Borowitz, D. J. Pullen, C. I. Civin

Research output: Contribution to journalArticlepeer-review

131 Scopus citations


Cell surface phenotypes of 113 B lineage acute lymphocytic leukemia (ALL) cases, defined by the presence of HLA-DR and at least one B-cell-specific antigen (either CD19, CD20, or CD22), were compared with antigen-defined stages of normal B lymphocyte development. The cases were first evaluated for expression of HLA-DR, CD19, CD34, CD10, CD20, and CD22 by indirect one-color immunofluorescence. Pairwise comparisons of cell surface marker expression were performed for each leukemic sample: no correlations were observed for paired antigen expression on the leukemic samples using antigens expressed either early or late during normal B lymphoid development. Complete immunophenotypes of the cases were then compared with normal B-cell developmental stages. Sixteen different complete immunophenotypes were observed on the leukemias that were not found in normal marrow; at least 78% of the cases demonstrated such 'asynchronous' combinations of B lymphoid-associated differentiation antigens. Several samples were subsequently studied by two-color immunofluorescence, and the presence of doubly labeled cells with 'asynchronous' antigen combinations was confirmed. These results indicate that the majority of B lineage leukemias exhibit 'developmental asynchrony', as compared with normal marrow B cells. The data further suggest that ALL cases do not accurately represent cells arrested at the stage where the leukemogenic event occurred. Rather, ALL appears to be a disease in which there may be maturation of leukemic blasts; but this maturation is 'asynchronous' when compared with the normal developmental process.

Original languageEnglish (US)
Pages (from-to)299-307
Number of pages9
Issue number1
StatePublished - 1988

ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology


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