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Definition of acute biphenotypic leukemia
E Matutes1, R Morilla, N Farahat
1Academic Department of Hematology and Cytogenetics, Royal Marsden Hospital, London, UK. estella@icr.ac.uk
Haematologica
|January 1, 1997
Summary
Biphenotypic acute leukemias (BAL) are rare, difficult to diagnose, and carry a poor prognosis. This study analyzes diagnostic criteria for BAL, suggesting intensive treatment is necessary for eradication.
Area of Science:
- Hematology
- Oncology
- Immunophenotyping
Background:
- Biphenotypic acute leukemia (BAL) presents challenges in diagnosis due to mixed myeloid and lymphoid features.
- Distinguishing BAL from acute myeloid leukemia (AML) or acute lymphoblastic leukemia (ALL) with aberrant markers is difficult due to lack of objective criteria.
Purpose of the Study:
- To analyze diagnostic criteria for biphenotypic acute leukemia (BAL).
- To investigate the clinico-biological entity of BAL.
Main Methods:
- Utilized a scoring system based on lymphoid and myeloid marker expression by blasts.
- Analyzed features of 26 patients diagnosed with BAL at the Royal Marsden Hospital.
- Applied European Group for the Immunological Classification of Leukemia (EGIL) criteria.
Main Results:
- BAL can present as ALL or AML (often M1 subtype) according to FAB criteria.
- Common immunophenotype involves coexpression of B-lymphoid and myeloid markers, or T-lymphoid and myeloid markers.
- BAL exhibits a high incidence of chromosomal abnormalities, including t(9;22) and 11q23, associated with a poor prognosis.
Conclusions:
- BAL is an uncommon leukemia likely arising from multipotent progenitor cells, carrying a poor prognosis.
- Intensive therapy, potentially including high-dose chemotherapy and bone marrow transplantation, is likely required for BAL eradication.