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Background:Lymphocyte precursors in B-lineage acute lymphoblastic leukemia (B-ALL) express the pan B-cell marker CD19 in the most cases. However, CD19 may not be detected in rare cases of B-ALL. It would be a challenge to diagnose by flow cytometry (FC), monitor residual disease and study future target therapy of B-ALL without CD19 expression.

Early T-cell precursor acute lymphoblastic leukemia (ETP-ALL) is a distinct entity according to the updated (2016) WHO classification due to its particular immunophenotypic and genomic profile. The molecular genetic abnormalities and their prognostic impact in ETP-ALL patients are poorly understood. Moreover, the diagnosis and management of this entity is still challenging.