Promising markers in T-cell acute lymphoblastic leukemia and their clinical application

T-cell acute lymphoblastic leukemia (T-ALL) is a highly heterogeneous malignancy characterized by diverse immunophenotypic profiles. Using flow cytometry, this study delineates the expression patterns of CD38, CD99, CD127, CD135, CD147, and TRBC1 across T-ALL subtypes. Understanding the mechanisms and pathogenesis associated with these markers facilitates the development of prognostic methods and therapeutic strategies. This research investigates newly identified or previously known antigens with novel potential, spanning studies conducted between 2013 and 2025. While some of these antigens are already recognized by the WHO, we provide new insights into their significance. These markers might play a crucial role in determining future prognosis and treatment outcomes. The study discusses the synergistic effects of anti-CD38 monoclonal antibodies with chemotherapy and highlights the role of CD99 in central nervous system involvement. It demonstrates the sensitivity of CD127 expression to specific therapies and explores the potential of CD135 as a novel therapeutic antigen. Moreover, combining TRBC1, CD127, or CD99 with existing markers may help differentiate reactive or malignant T cells, refine T-ALL subtype classification, and monitor CNS protection during therapy. The study also presents evidence supporting the efficacy of anti-CD38, anti-CD99, anti-CD147, and anti-TRBC1 CAR-T cell therapies in improving treatment outcomes for T-ALL.