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Mixed-phenotype acute leukemia characteristics: first report from Iran
Behzad Poopak1,2, Adnan Khosravi3, Gholamreza Bahoush-Mehdiabadi4
1Islamic Azad University, Tehran Medical Sciences Branch, Tehran, Iran. bpoopak@gmail.com.
Clinical and Experimental Medicine
|July 19, 2018
Summary
This study highlights the diagnostic challenges of mixed-phenotype acute leukemia (MPAL) in Iran. Utilizing WHO 2016 criteria and flow cytometry, researchers identified key immunophenotypic markers for accurate MPAL subtyping.
Area of Science:
- Hematology
- Oncology
- Immunophenotyping
Background:
- Mixed-phenotype acute leukemia (MPAL) presents diagnostic challenges due to its dual lineage characteristics.
- Accurate diagnosis is crucial for appropriate treatment and patient outcomes.
Purpose of the Study:
- To analyze immunophenotyping, cytochemistry, and frequency of MPAL patients in Iran.
- To better diagnose MPAL characteristics using WHO 2016 criteria.
- To identify key immunophenotypic markers for MPAL subsets.
Main Methods:
- Retrospective analysis of 27 MPAL patients diagnosed between 2014-2017.
- Flow cytometric immunophenotyping of peripheral blood (PB) and bone marrow (BM) samples.
- RT-PCR for BCR/ABL1 fusion analysis.
Main Results:
- MPAL comprised B+My (70.4%), T+My (22.22%), and B+T+My (7.40%) subtypes.
- Specific CD marker expressions (e.g., CD34, CD19, HLA-DR, TdT, CD22, iMPO for B+My) were identified for each subtype.
- BCR/ABL1 fusion was detected in 11.1% (p190) and 7.4% (p210) of B+My cases.
Conclusions:
- WHO 2016 criteria are essential for MPAL diagnosis.
- Flow cytometry evaluation of specific markers (TdT, CD2, CD5, CD7) aids in MPAL subset diagnosis.
- Incorporating BCR/ABL1 and MLL rearrangement analysis into standard work-up is recommended.
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