Mixed-Phenotype Acute Leukemia: Diagnostic Criteria and Pitfalls

Area of Science:

• Hematology
• Oncology
• Immunophenotyping

Background:

• Mixed-phenotype acute leukemia (MPAL) is a complex WHO-classified leukemia.
• It involves discrete myeloid and lymphoid blast populations or single blasts coexpressing myeloid and lymphoid markers.
• Diagnostic uncertainty and unfamiliarity pose challenges for clinicians.

Purpose of the Study:

• To elucidate the diagnostic criteria for MPAL.
• To summarize the biological and clinical characteristics of MPAL.
• To address common diagnostic pitfalls in MPAL cases.

Main Methods:

• Review of existing literature and classification systems (WHO).
• Analysis of flow cytometric findings in MPAL.
• Synthesis of clinical and biological data.

Main Results:

• MPAL is defined by specific immunophenotypic patterns.
• Distinct biological and clinical features characterize MPAL subtypes.
• Common pitfalls include misinterpretation of blast phenotypes.

Conclusions:

• Clear diagnostic criteria are essential for accurate MPAL identification.
• Understanding MPAL's biology aids in its classification and management.
• Addressing diagnostic challenges improves patient care for these rare leukemias.