Introduction: Early T-cell precursor acute lymphoblastic leukemia (ETP-ALL) is a subtype of T-ALL and its clinical entity was established in recent years based on characteristic immunophenotyping and gene expression profiles. The cellular origin of ETP-ALL is supposed to be from common hematopoietic progenitors both for lymphoid and myeloid lineages because this leukemia phenotypically exhibits lymphoid, myeloid, and stem cell features. ETP-ALL comprises 5–15% of all T-ALL and is associated with a poor prognosis. The purpose of this chapter is to clarify the etiology, clinical picture, and therapeutic strategy of ETP-ALL showing two cases of this leukemia in our institution.
Part of the book: Leukemias
Viral reactivation is one of the most serious complications for immunocompromised patients. Under immunosuppressive conditions, some viruses can be reactivated solely or simultaneously and may thus cause life-threatening infection. Therefore, the prompt and proper diagnosis of viral reactivation is important for the initiation of preemptive therapy. For this purpose, we recently developed a multiplex-virus polymerase chain reaction (PCR) assay. The multiplex PCR assay is designed to qualitatively measure the genomic DNA of 12 viruses at once: cytomegalovirus (CMV), human herpesvirus type 6 (HHV-6), HHV-7, HHV-8, Epstein-Barr virus (EBV), varicella-zoster virus (VZV), BK virus (BKV), JC virus (JCV), parvovirus B19 (ParvoB19), herpes simplex virus type 1 (HSV-1), HSV-2, and hepatitis B virus (HBV). When a specific PCR signal is obtained, the viral load is determined by a quantitative real-time PCR. The qualitative multiplex and quantitative real-time PCR procedures take only 3 hours to complete. With this assay system, we can identify viremia at the early stage and thereby prevent it from progressing to overt and symptomatic viral infection in immunocompromised patients, such as those receiving hematopoietic stem cell transplantation.
Part of the book: Polymerase Chain Reaction for Biomedical Applications