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Blood, 15 December 2004, Vol. 104, No. 13, pp. 4173-4180.
Prepublished online as a Blood First Edition Paper on March 30, 2004; DOI 10.1182/blood-2003-11-3944.
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Submitted November 21, 2003
Accepted March 21, 2004
Age-related phenotypic and oncogenic differences in T-Acute Lymphoblastic Leukemias may reflect thymic atrophy
Vahid Asnafi, Kheira Beldjord, Martha Libura, Patrick Villarese, Corinne Millien, Paola Ballerini, Emilienne Kuhlein, Marina Lafage-Pochitaloff, Eric Delabesse, Olivier Bernard, and Elizabeth Macintyre*
Biological hematology, Necker-Enfants-Malades Hospital, Paris, France; INSERM EMIU210 and University of Paris V, Paris, France
Biological hematology, Necker-Enfants-Malades Hospital, Paris, France
Biological hematology, Armand-Trousseau Hospital, Paris, France
Cytogenetic, Purpan Hospital, Toulouse, France
Cytogenetic, Institut Paoli Calmette, Marseille, France
INSERM EMIU210 and University of Paris V, Paris, France
* Corresponding author; email: elizabeth.macintyre{at}nck.ap-hop-paris.fr.
Post natal thymic involution occurs progressively throughout the first 3 decades of life. It predominantly affects T Cell Receptor (TCR)  -lineage precursors, with a consequent proportional increase in multipotent thymic precursors. We show that T Acute Lymphoblastic Leukemias (T-ALLs) demonstrate a similar shift with age from predominantly TCR expressing to an immature (IM0/ / ) stage of maturation arrest. Half demonstrate HOX11, HOX11L2, SIL-TAL or CALM-AF10 deregulation, with each being associated with an, age independent, specific stage of maturation arrest. HOX11 and SIL-TAL represent  -lineage oncogenes, whereas HOX11L2 expression indentifies an intermediate  / / lineage stage of maturation arrest. In keeping with preferential  -lineage involution, the incidence of SIL-TAL and HOX11L2 deregulation decreased with age. In contrast, HOX11 deregulation became more frequent, suggesting longer latency. TAL1 deregulation is more frequent in  -lineage T-ALL, when it is predominantly due to SIL-TAL rearrangements in children but to currently unknown mechanisms in adolescents and adults. LMO2 was more frequently co-expressed with LYL1, predominantly in IM0/ / ) adult cases, than with TAL1. These age related changes in phenotype and oncogenic pathways probably reflect progressive changes in the thymic population at risk of malignant transformation.

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