Automated database-guided expert-supervised orientation for immunophenotypic diagnosis and classification of acute leukemia

Precise classification of acute leukemia (AL) is crucial for adequate treatment. EuroFlow has previously designed an AL orientation tube (ALOT) to guide towards the relevant classification panel (T-cell acute lymphoblastic leukemia (T-ALL), B-cell precursor (BCP)-ALL and/or acute myeloid leukemia (AML)) and final diagnosis. Now we built a reference database with 656 typical AL samples (145 T-ALL, 377 BCP-ALL, 134 AML), processed and analyzed via standardized protocols. Using principal component analysis (PCA)-based plots and automated classification algorithms for direct comparison of single-cells from individual patients against the database, another 783 cases were subsequently evaluated. Depending on the database-guided results, patients were categorized as: (i) typical T, B or Myeloid without or; (ii) with a transitional component to another lineage; (iii) atypical; or (iv) mixed-lineage. Using this automated algorithm, in 781/783 cases (99.7%) the right panel was selected, and data comparable to the final WHO-diagnosis was already provided in >93% of cases (85% T-ALL, 97% BCP-ALL, 95% AML and 87% mixed-phenotype AL patients), even without data on the full-characterization panels. Our results show that database-guided analysis facilitates standardized interpretation of ALOT results and allows accurate selection of the relevant classification panels, hence providing a solid basis for designing future WHO AL classifications

ALLTogether recommendations for biobanking samples from patients with acute lymphoblastic leukaemia: a modified Delphi study: Clinical Studies

\ua9 The Author(s) 2025.Acute lymphoblastic leukaemia (ALL) is a rare and heterogeneous disease. The ALLTogether consortium has implemented a treatment protocol to improve outcome and reduce treatment-related toxicity across much of Europe. The consortium provides the opportunity to design translational research on patient material stored in national biobanks. However, there are currently no standardized guidelines for the types of material, processing, and storage for leukaemia biobanking. To address this gap, we conducted a modified Delphi survey among 53 experts in different roles related to leukaemia. The first round consisted of 63 statements asking for level of agreement. The second round refined some to reach consensus, using yes-no and multiple-option answers. Key recommendations include cryopreservation of cells from diagnosis, post-induction, post-consolidation, and relapse, with at least two aliquots of plasma and serum, and cerebrospinal fluid from diagnosis, day15, and post-induction. It was advised to distribute cells across multiple vials for various research projects, and to collect data on sample processing, cell viability, and blast percentage. Quality monitoring and user feedback were strongly recommended. The Delphi survey resulted in strong recommendations that can be used by national biobanks to harmonize storage of samples from patients with ALL and ensure high-quality cryopreserved cells for research studies

Age-related clinical and biological features of PTEN abnormalities in T-cell acute lymphoblastic leukaemia

International audienceThe tumour suppressor gene PTEN is commonly altered in T-cell acute lymphoblastic leukaemia but its prognostic impact is still debated. We screened a cohort of 573 fully characterised adult and paediatric T-cell acute lymphoblastic leukaemia (TALL) patients for genomic PTEN abnormalities. PTEN-inactivating mutations and/or deletions were identified in 91 cases (16%), including 18% of paediatric (49/277) and 14% of adult cases (42/296). Thirty-four patients harboured only mutations, 12 cases demonstrated only large deletions and 9 only microdeletions. About 36 patients had combined alterations. Different mechanisms of PTEN inactivation predicted differences in the clinical outcome for both adult and paediatric patients treated according to the GRAALL03/05 and FRALLE2000 protocols. Whereas large deletions predicted lower 5-year overall survival (P = 0.0053 in adults, P = 0.001 in children) and disease-free survival (P = 0.0009 in adults, P = 0.0002 in children), mutations were not associated with a worse prognosis. The prognostic impact of PTEN loss is therefore linked to the underlying type of genomic abnormality, both in adult and paediatric T-ALLs, demonstrating that detailed analysis of the type of abnormality type would be useful to refine risk stratification

Comparison of Two Fixed Beta-Blocker-Pilocarpine Combinations

Purpose To compare the efficacy and safety of a newly developed ophthalmic solution containing carteolol 2% and pilocarpine (2% (CBS341A) with a timolol 0.5% and pilocarpine 2% fixed combination. Patients and Methods. A randomized, double-masked, multicenter study was conducted in 209 patients with primary open-angle glaucoma or ocular hypertension, whose intraocular pressure (IOP) was higher than 21 mm Hg on bet-blocker twice a day alone. The test medications were administered twice daily for 4 months. IOP was measured at 9 and 11 a.m. at the beginning of the study (with beta-blocker alone) and after one and four months of treatment. Adverse effects were recorded. Results Both combinations caused a similar, statistically significant decrease in IOP. At four months, in the CBS341A group a 2.4 mm Hg (9%) reduction in IOP was achieved at 9 a.m. and 4.1 mm Hg (17.3%) at 11 a.m. compared with respectively 3 mm Hg (11%) and 4.5 mm Hg (19.5%) in the timolol-pilocarpine group. No statistical difference was observed between the two groups in safety and efficacy. Conclusions The carteolol-pilocarpine combination appears as safe and as effective as the timolol-pilocarpine combination in the medical treatment of primary open-angle glaucoma or ocular hypertension. </jats:sec

TCRα rearrangements identify a subgroup of NKL-deregulated adult T-ALLs associated with favorable outcome

International audienceno abstrac

Receptor kinase profiles identify a rationale for multi-target kinase inhibition in immature T-ALL.

International audienc