Lineage infidelity

It is sometimes impossible to define a single lineage for leukaemic blasts on the basis of phenotypic marker expression. The expression of markers of more than one cell lineage by a leukaemic cell is termed lineage infidelity and may reflect abnormal gene expression in the clone or abnormal maturation of an early uncommitted precursor. Blasts can display cyto-chemical and immunophenotypic markers of both myeloid and lymphoid precursors. Up to 50% of myeloid leukaemias may be positive for lymphoid antigens, most commonly CD2 (34%) and CD7 (42%) and this does not appear to have prognostic significance.

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