Use of Immunofluorescence Tests for TdT in Human Hematologic Malignancy
Terminal deoxynucleotidyl transferase (TdT) has been established as a valuable clinical tool in the differential diagnosis of acute leukemia. In pediatric disease, TdT is almost uniformly elevated in tumor cells for “T” cell and “Common” acute lymphoblastic leukemia (ALL) and in selected patients with “Pre B” ALL. In adult leukemias TdT is highly elevated in chronic myelogenous leukemia (CML in blast crisis)(30% of cases) and in undifferentiated leukemia (AUL) in acute phase (50% of cases). Patients with acute myeloid leukemia (AML) will occasionally exhibit high levels of TdT activity (10% of cases).1 Detection of TdT in leukemic cells is important clinically because it is indicative of responsiveness of the disease to chemotherapeutic protocols containing vincristine and prednisone.
KeywordsAcute Myeloid Leukemia Acute Lymphoblastic Leukemia Chronic Myelogenous Leukemia Terminal Deoxynucleotidyl Transferase Blast Crisis
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