Semenzato Gianpietro, Teramo Antonella, Calabretto Giulia, Zambello Renato
University of Padova, Department of Medicine, Hematology Unit; Veneto Institute of Molecular Medicine, Padova.
Haematologica. 2025 Jan 1;110(1):37-46. doi: 10.3324/haematol.2024.286023.
T-cell large granular lymphocyte clones that persist over time and that exhibit molecular and immunophenotypic features closely resembling those of T-cell large granular lymphocyte leukemia (T-LGLL) may be detectable in individuals who lack any clinical or laboratory features supporting a diagnosis of a T-cell malignancy. This condition represents a potential precursor state termed T-cell clones of uncertain significance (T-CUS). T-CUS represents the even more benign extreme of the wide spectrum of clonal T-large granular lymphocyte proliferations, emphasizing the need for an appropriate multiparametric diagnostic assessment that avoids misdiagnosis of T-cell neoplasia. This approach should overcome numerical cut-offs as the sole criteria to differentiate the benign condition from the related malignancies. In particular, genomic aberrancies might prospectively identify individuals who are at risk of progression to a full-blown T-cell malignancy. We herein discuss the significance of these T-cell clones in both healthy and disease states, suggesting molecular assays for tracking early steps of disease.
随着时间推移持续存在且表现出与T细胞大颗粒淋巴细胞白血病（T-LGLL）极为相似的分子和免疫表型特征的T细胞大颗粒淋巴细胞克隆，可能在缺乏任何支持T细胞恶性肿瘤诊断的临床或实验室特征的个体中被检测到。这种情况代表了一种潜在的前驱状态，称为意义未明的T细胞克隆（T-CUS）。T-CUS代表了广泛的克隆性T大颗粒淋巴细胞增殖谱中更为良性的一端，强调了进行适当的多参数诊断评估的必要性，以避免T细胞肿瘤的误诊。这种方法应克服将数值临界值作为区分良性情况与相关恶性肿瘤的唯一标准。特别是，基因组异常可能前瞻性地识别出有进展为完全成熟T细胞恶性肿瘤风险的个体。我们在此讨论这些T细胞克隆在健康和疾病状态下的意义，提出用于追踪疾病早期阶段的分子检测方法。
