Clinical characteristics, biological profile, and outcome of biphenotypic acute leukemia: a case series.

Abstract

BACKGROUND:

Biphenotypic acute leukemia (BAL) is a rare type of acute leukemia that presents with a high degree of heterogeneity and is not well defined.

METHODS:

We identified 51 cases (3%) of BAL from 1,693 newly diagnosed acute leukemia patients according to the EGIL scoring system. The immunophenotyping, cytogenetics, treatment, and outcome of 39 BAL patients were retrospectively analyzed.

RESULTS:

There were 23 (59%) cases of the myeloid and B-lymphoid phenotype, 14 (36%) cases of the myeloid and T-lymphoid phenotype, and 1 case (3%) of the trilineage phenotype or B/T phenotype. Abnormal karyotypes were detected in 76% of the 37 validated patients and displayed a high degree of heterogeneity. Combined regimens for both acute myeloid leukemia (AML) and acute lymphoid leukemia (ALL), as well as ALL type regimens, appeared to achieve a better complete remission rate than AML type regimens (71 and 64 vs. 33%, respectively). BAL patients with complex karyotypes or a rearrangement of chromosome 11 had a significantly reduced survival rate in comparison to patients with normal, t(8; 21), or t(9; 22) karyotypes. The probability of overall survival and disease-free survival at 2 years was 26 and 18%, respectively.

CONCLUSIONS:

Our findings indicate that BAL shows a high incidence of abnormal karyotypes and a poor prognosis. Combined-type regimens or ALL-based protocols are effective for the treatment of BAL.

• Authors: Yanming Zhang, Depei Wu, Aining Sun, Huiying Qiu, Guangsheng He, Zhengming Jin, Xiaowen Tang, Miao Miao, Zhengzheng Fu, Yue Han
• Journal: Acta haematologica (Acta Haematol) Vol. 125 Issue 4 Pg. 210-8 ( 2011) ISSN: 1421-9662 [Electronic] Switzerland
• PMID: 21266800 (Publication Type: Journal Article)
• Copyright: Copyright © 2011 S. Karger AG, Basel.

Topics

• Adolescent
• Adult
• Child
• Child, Preschool
• Female
• Humans
• Immunophenotyping
• Leukemia, Biphenotypic, Acute (diagnosis, drug therapy, genetics, mortality)
• Male
• Middle Aged
• Prognosis
• Retrospective Studies
• Treatment Outcome
• Young Adult