Clinico-hematological profile in biphenotypic acute leukemia

Area of Science:

• Hematology
• Oncology
• Immunology

Background:

• Presents the clinico-hematological profile and treatment outcomes of Biphenotypic Acute Leukemia (BAL).
• Highlights the importance of accurate diagnosis and understanding prognostic factors in BAL.

Purpose of the Study:

• To determine the incidence and subtypes of BAL.
• To correlate clinico-hematological data with treatment response.
• To compare diagnostic criteria (St. Jude's and EGIL's) for BAL.

Main Methods:

• Diagnosis based on WHO classification, incorporating clinical, morphological, cytochemical, immunophenotypic, and molecular genetic data.
• Inclusion of cases meeting the European Group for the Immunological Characterization of Acute Leukemia's (EGIL's) scoring system criteria.
• Utilized a comprehensive panel of reagents, including cytoplasmic markers, for diagnosis.

Main Results:

• 32 BAL cases diagnosed using EGIL's criteria, with an incidence of 1.2%.
• B-Myeloid (14) and T-Myeloid (13) BAL were the most frequent subtypes.
• BCR-ABL fusion positivity observed in seven cases; 8 of 15 patients receiving chemotherapy achieved complete remission.

Conclusions:

• Pediatric and T-B lymphoid BAL exhibit a better prognosis.
• St. Jude's criteria offer a simple, cost-effective diagnostic method for BAL.
• Prognostic factors include age, HLA-DR, CD34 negativity, and BAL subtype; BCR-ABL expression necessitates CML blast crisis treatment.