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Mixed Phenotype Acute Leukemia with B/T Lineage and BCR-ABL1 Rearrangement: a Case Report and Literature Review
Clinical Laboratory
|May 20, 2026
Summary
This case study presents a rare B/T mixed phenotype acute leukemia (MPAL) with BCR-ABL1 rearrangement. Prompt treatment with tyrosine kinase inhibitors led to complete remission, highlighting effective management strategies for this aggressive leukemia.
Area of Science:
- Hematology
- Oncology
- Molecular Diagnostics
Background:
- Mixed phenotype acute leukemia (MPAL) is a rare and aggressive hematologic malignancy.
- BCR-ABL1 rearrangement is typically associated with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL).
Purpose of the Study:
- To report a rare case of B/T MPAL with BCR-ABL1 rearrangement.
- To discuss the diagnostic challenges and treatment outcomes for this specific leukemia subtype.
Main Methods:
- Case presentation of a 35-year-old male with hemorrhage, infection, and hemodynamic instability.
- Laboratory analysis including peripheral blood and bone marrow smears, immunophenotyping, and fluorescence in situ hybridization (FISH).
- FISH confirmed the presence of the BCR-ABL1 fusion gene.
Main Results:
- The patient presented with bicytopenia and myeloperoxidase-negative blasts.
- Immunophenotyping revealed coexisting T-lineage and B-lineage populations.
- The diagnosis was confirmed as B/T MPAL with BCR-ABL1 rearrangement.
Conclusions:
- BCR-ABL1-positive B/T MPAL is a complex and aggressive leukemia.
- Treatment with tyrosine kinase inhibitors achieved complete remission.
- The patient is awaiting matched sibling donor transplantation, underscoring the need for timely and targeted therapies.
