Auer rod-positive acute leukemia with predominantly lymphoid immunophenotype: Report on 11 cases and review of literature
Language English Country United States Media print-electronic
Document type Journal Article
Grant support
Univerzita Karlova v Praze
European Union and state budget of Czechia
Ministerstvo Zdravotnictví Ceské Republiky
PubMed
39415351
DOI
10.1002/pbc.31394
Knihovny.cz E-resources
- Keywords
- Auer rods, biphenotypic acute leukemia, early T‐cell precursor lymphoblastic leukemia,
- MeSH
- Precursor Cell Lymphoblastic Leukemia-Lymphoma pathology therapy immunology MeSH
- Leukemia, Myeloid, Acute pathology therapy immunology MeSH
- Child MeSH
- Immunophenotyping * MeSH
- Infant MeSH
- Humans MeSH
- Adolescent MeSH
- Follow-Up Studies MeSH
- Child, Preschool MeSH
- Check Tag
- Child MeSH
- Infant MeSH
- Humans MeSH
- Adolescent MeSH
- Male MeSH
- Child, Preschool MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
BACKGROUND: Auer rods (AuRs) are prominent intracellular structures found almost exclusively in myeloid cell malignancies, such as acute myeloid leukemia (AML), chronic and juvenile myelomonocytic leukemia and myelodysplastic syndrome. Extremely rare AuRs have been reported in patients with acute lymphoblastic leukemia (ALL) or among ambiguous lineage leukemia patients with a dominantly lymphoblastic immunophenotype. PROCEDURE: We report diagnostic and follow-up data of an international cohort of 11 children suffering from leukemias with AuRs and with significant presence of T and myeloid markers, majority of whom categorized as early T-cell precursor (ETP, n = 7); or T-ALL (ETP status unknown, n = 2), ALAL (acute leukemia of ambiguous lineage, n = 1), and AML reclassified from ALAL (n = 1). We described other diagnostic details and treatment types and responses. Moreover, we summarize previously published data. RESULTS: Among the four patients who started and remained on ALL-type therapy, all were in the first complete remission, whereas both patients who started and remained on AML-type therapy relapsed and died. Of the patients who followed either a combined ALL/AML protocol (Interfant 06) or who switched from one of the two types of therapy to the other, one patient died, and the remaining four were in first complete remission at the most recent follow-up. We also searched for similar cases in the literature and found only three additional children with nonmyeloid leukemia and AuRs and 10 adults with this type of leukemia. CONCLUSIONS: Briefly, ALL- or combined ALL/AML-type therapy may be effective for treating AuR-positive leukemia patients with a lymphoid immunophenotype.
CLIP Charles University Prague Czech Republic
Department of Cell Biology Faculty of Science Charles University Prague Czech Republic
Department of Clinical Hematology Motol Hospital Prague Czech Republic
Department of Laboratory Medicine National Institute of Children's Diseases Bratislava Slovakia
Department of Paediatrics University Medical Centre Schleswig Holstein Campus Kiel Kiel Germany
Department of Pediatric Hematology and Oncology Motol Hospital Prague Czech Republic
See more in PubMed
McCrae T. Acute lymphatic leukaemia, with the report of five cases. Br Med J. 1905;1(2304):404‐408.
Auer J. Some hitherto undescribed structures found in the large lymphocytes of a case of acute leukaemia. Am J Med Sci. 1906;131:1002‐1014.
Bain BJ. Auer rods or McCrae rods? Am J Hematol. 2011;86(8):689.
Dunphy CH, Chung D, Dunphy FR. Auer rod‐like inclusions in adult common acute lymphoblastic leukemia. Hum Pathol. 1994;25(2):211‐214.
Sehgal T, Sharma P. Auer rods and faggot cells: a review of the history, significance and mimics of two morphological curiosities of enduring relevance. Eur J Haematol. 2023;110(1):14‐23.
Ru YX, Dong SX, Liu J, Eyden B. Development of Auer bodies from giant inclusions associated with rough endoplasmic reticulum in acute promyelocytic leukemia. Blood Sci. 2023;5(2):111‐117.
Huang H, Qin T, Xu Z, et al. Mutational features of myelodysplastic syndromes with Auer rods reveal them are more akin to acute myeloid leukemia. Br J Haematol. 2020;188(5):796‐800.
Arber DA, Orazi A, Hasserjian R, et al. The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia. Blood. 2016;127(20):2391‐2405.
Gupta A, Reddy GK, Nalla N, Goyal M. Lymphoblasts with Auer rod‐like inclusions in a case of paediatric B lymphoblastic leukemia. Pediatr Blood Cancer. 2017;64(7):2016‐2017.
Gajendra S, Sachdev R, Dorwal P, et al. Mixed‐phenotypic acute leukemia: cytochemically myeloid and phenotypically early T‐cell precursor acute lymphoblastic leukemia. Blood Res. 2014;49(3):196‐198.
Feng Y, Fu J. Auer rods aid in the diagnosis of mixed phenotype acute leukemia. Int J Hematol. 2021;113(3):313‐314.
Wang Y, Zhang Z, Xi L, Wang H, Dong F. Early T‐cell precursor acute lymphoblastic leukemia with Auer rods in mature granulocytes. Int J Lab Hematol. 2022;44(2):e52‐e54.
Rahman K, Singh P, Chandra D, et al. Early T‐cell precursor acute lymphoblastic leukemia with Auer rods—a case report. Int J Lab Hematol. 2020;42(1):e27‐e29.
Dmitrienko S, Vercauteren S. Auer rods in mature granulocytes of a patient with mixed lineage leukemia. Blood. 2012;119(19):4348.
Li Y, Yang W, Wang W, et al. Auer rods in mixed phenotype acute leukemia, T/myeloid: a report of three cases. Leuk Res Rep. 2021;15:100236.
Kabbage S, Cupaiolo R, Rozen L, Demulder A. Auer rods in neutrophils in bone marrow and peripheral blood in mixed phenotype acute leukaemia in a child. Br J Haematol. 2019;184(5):708.
Aruga Y, Arakawa A, Ono K, Ogawa C, Matsushita H. Pseudo‐Chédiak–Higashi granules and Auer rods in mixed phenotype acute leukaemia, T/myeloid, not otherwise specified. Br J Haematol. 2018;180(2):175.
Chang H, Eladl E. Multiple Auer rods in a mixed‐phenotype acute leukemia. Blood. 2021;137(12):1702.
Hristov AC, Saladino A, Nava VE, Gocke CD. Auer rod‐like inclusions in a low‐grade B‐cell leukemia. Ann Diagn Pathol. 2010;14(4):292‐295.
Roldán Galiacho V, Lobo Olmedo A, Aranguren del Castillo L, Arzuaga‐Mendez J, García‐Ruiz JC. Lymphocytes with auer rod‐like inclusions in chronic lymphocytic leukemia. Hematol Transfus Cell Ther. 2022;44(4):616‐617.
Metzgeroth G, Back W, Maywald O, et al. Auer rod‐like inclusions in multiple myeloma. Ann Hematol. 2003;82(1):57‐60.
HÜtter G, Nowak D, Blau IW, Thiel E. Auer rod‐like intracytoplasmic inclusions in multiple myeloma. A case report and review of the literature. Int J Lab Hematol. 2009;31(2):236‐240.
Gao Z, Cui F, Liu M, et al. Auer rod‐like inclusions in the cytoplasm of B‐cell lymphoma cells with bone marrow infiltration. Exp Hematol. 2019;77:6‐11.
Lemez P. Auer‐rod‐like inclusions in cells of B‐lymphocytic lineage. Acta Haematol. 1988;80(3):177‐178.
Avval MM, Kumar PV, Dehghani F. Multiple auer rods in fine‐needle aspiration smears of medullary thyroid carcinoma: an unusual finding. Int Med Case Rep J. 2020;13:85‐88.
Khoury JD, Solary E, Abla O, et al. of the World Health Organization classification of haematolymphoid tumours: myeloid and histiocytic/dendritic neoplasms. Leukemia. 2022;36(7):1703‐1719.
Hrusak O, De Haas V, Stancikova J, et al. International cooperative study identifies treatment strategy in childhood ambiguous lineage leukemia. Blood. 2018;132(3):264‐276.
Dworzak MN, Buldini B, Gaipa G, et al. AIEOP‐BFM consensus guidelines 2016 for flow cytometric immunophenotyping of pediatric acute lymphoblastic leukemia. Cytometry B Clin Cytom. 2018;94(1):82‐93.
Hrušák O, Basso G, Ratei R, et al. Flow diagnostics essential code: a simple and brief format for the summary of leukemia phenotyping. Cytometry B Clin Cytom. 2014;86(4):n/a‐n/a.
Zaliova M, Stuchly J, Winkowska L, et al. Genomic landscape of pediatric B‐other acute lymphoblastic leukemia in a consecutive European cohort. Haematologica. 2019;104(7):1396‐1406.
Inukai T, Kiyokawa N, Campana D, et al. Clinical significance of early T‐cell precursor acute lymphoblastic leukaemia: results of the Tokyo Children's Cancer Study Group Study L99‐15. Br J Haematol. 2012;156(3):358‐365.
Coustan‐Smith E, Mullighan CG, Onciu M, et al. Early T‐cell precursor leukaemia: a subtype of very high‐risk acute lymphoblastic leukaemia. Lancet Oncol. 2009;10(2):147‐156.
Pölönen P, Di Giacomo D, Seffernick AE, et al. The genomic basis of childhood T‐lineage acute lymphoblastic leukaemia. Nature. 2024;632(8027):1082‐1091.
Annesley CE, Brown P. The biology and targeting of FLT3 in pediatric leukemia. Front Oncol. 2014;4:263.
Wood BL, Winter SS, Dunsmore KP, et al. T‐lymphoblastic leukemia (T‐ALL) shows excellent outcome, lack of significance of the early thymic precursor (ETP) immunophenotype, and validation of the prognostic value of end‐induction minimal residual disease (MRD) in Children's Oncology Group (COG) study. Blood. 2014;124(21):1.
