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Am J Clin Pathol. 2009 Aug;132(2):182-5; quiz 306. doi: 10.1309/AJCPZ7E9IMXVSNPT.

Acute lymphoblastic leukemia with Burkitt-like morphologic features and high myeloperoxidase activity.

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Pediatric Department, M.D. Anderson Cancer Center, University of Texas, 1515 Holcombe Blvd, Box 87, Houston, TX 77030, USA.


Expression of a high level of myeloperoxidase (MPO) as a sole myeloid marker in acute leukemias that express typical lymphoblastic markers is unusual. Herein we report 5 cases of MPO+, otherwise typical acute lymphoblastic leukemia (ALL) without the expression of other myeloid markers. In most cases, MPO positivity was detected in more than 20% of blasts by immunologic (flow cytometric) and enzymatic testing. The striking feature of most of these cases is a morphologic picture reminiscent of that seen in Burkitt-like B-cell ALL with basophilic cytoplasm and vacuoles but no expression of surface immunoglobulin. All cases responded to ALL therapy and should be distinguished from myeloid leukemia and from Burkitt leukemia/lymphoma.

[Indexed for MEDLINE]

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