A 4-year-old girl presents to the emergency department with | Figure 1

A 4-year-old girl presents to the emergency department with multiple bruises on her limbs and recent weight loss of 4 lb. When asked, the patient’s mother reports that the child has been progressively fatigued and seems to be weak. The patient’s past medical history is significant for hemophagocytic lymphohistiocytosis, for which she was treated with etoposide, corticosteroids, cyclosporine, and intrathecal methotrexate. She then received a bone marrow transplantation. Her current complete blood cell count shows anemia, thrombocytopenia, and marked lymphocytosis with 88% blasts. The peripheral smear is shown in Figure 1. Which one of the following statements regarding the phenotypic characteristics of acute leukemia is true?

A. CD19 expression is almost never observed in AML.

B. Terminal deoxynucleotidyl transferase (TdT) can be positive in a subset of AMLs.

C. It is not uncommon to see the absence of CD19 on B-cell lymphoblastic leukemias.

D. If the lesional cells express CD13, they must be of the myeloid lineage.

E. CD117 is commonly seen in ALL.

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