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Updated: Jun 22, 2026
Enumeration of Major Peripheral Blood Leukocyte Populations for Multicenter Clinical Trials Using a Whole Blood Phenotyping Assay
Published on: September 16, 2012
[Study on the clinical characteristics of adult biphenotypic acute leukaemia]
Jing Zhang1, Ying-Chang Mi, Ying Wang
1Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Science, Tianjin 300020, China.
Insights
Biphenotypic acute leukaemia (BAL) is a rare condition often presenting with high white blood cell counts and coexpression of myeloid/B lymphoid antigens. Prognosis for BAL patients is generally poor, particularly for those with Philadelphia chromosome or bcr-abl positivity.
Area of Science:
- Hematology
- Oncology
- Immunophenotyping
Context:
- Biphenotypic acute leukaemia (BAL) is a rare subtype of acute leukaemia.
- Characterized by coexisting myeloid and lymphoid features.
- Understanding its clinical and biological profile is crucial for effective management.
Purpose:
- To analyze the clinical and biological characteristics of adult biphenotypic acute leukaemia (BAL).
- To evaluate the prognosis of BAL patients.
- To correlate immunophenotypic and cytogenetic findings with treatment outcomes.
Summary:
- BAL incidence is 6.7% of acute leukaemias, with male predominance and frequent high white blood cell counts (>30 x 10(9)/L in 52.3%).
- Coexpression of myeloid and B lymphoid antigens is common (81.5%). Abnormal karyotypes (58.5%) and Philadelphia chromosome/bcr-abl positivity (32.1%) are frequent.
- Complete remission rates are suboptimal (56.4% overall, 35.3% for Ph+/bcr-abl+), indicating a poor prognosis.
Impact:
- Highlights the aggressive nature of BAL, characterized by specific immunophenotypic and cytogenetic abnormalities.
- Suggests that current treatment strategies may be insufficient for BAL, especially Ph+/bcr-abl+ cases.
- Emphasizes the need for further research into novel therapeutic approaches for improving BAL patient outcomes.
Objective:
To analyze the clinical and biological characteristics and prognosis of adult biphenotypic acute leukaemia (BAL).
Methods:
Immunophenotypes were analyzed using multicolor flow cytometry, karyotype analysis by short-term culture R-banding technique. The chemotherapy regimens were accordingly for acute lymphoblastic leukaemia (ALL), acute myeloid leukaemia (AML) or for both ALL and AML. Patients with Ph (+) or bcr-abl (+) were treated with Imatinib.
Results:
(1) The incidence of BAL in acute leukaemias was 6.7%, with a male predominance and 52.3% of BAL patients had WBC > or = 30 x 10(9)/L and 16.9% WBC > or = 100 x 10(9)/L. (2) Percentages of coexpression of myeloid and B lymphoid antigens were 81.5%, of myeloid and T lymphoid antigens 10.8%, of myeloid, B- and T lymphoid antigens 4.6%, and of B and T lymphoid antigens 3.1%. (3) Normal and abnormal karyotypes accounted for 41.5% and 58.5%, respectively in 53 BAL patients with karyotype analysis. The rate of Ph (+) or bcr-abl (+) was 32.1%. (4) 31 (56.4%) of 65 patients achieved complete remission (CR), but CR rate was only 35.3% for Ph (+) or bcr-abl (+) cases.
Conclusion:
(1) High white blood cell count and coexpression of myeloid/B lymphoid antigens are common in BAL. (2) Abnormal karyotypes and Ph (+) or bcr-abl( +) often happen. (3) The treatment outcome of BAL is poor.
