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Indian Journal of Cancer
Medknow Publications on behalf of Indian Cancer Society
ISSN: 0019-509X
EISSN: 1998-4774
Vol. 46, No. 2, 2009, pp. 160-168
Bioline Code: cn09031
Full paper language: English
Document type: Research Article
Document available free of charge

Indian Journal of Cancer, Vol. 46, No. 2, 2009, pp. 160-168

 en Clinico-Hematological Profile in Biphenotypic Acute Leukemia
Gujral, S.; Polampalli, S.; Badrinath, Y.; Kumar, A.; Subramanian, P.G.; Raje, G.; Amare, P.; Arora, B.; Banavali, S.D. & Nair, C.N.


Background : We present a clinico-hematological profile and treatment outcome of Biphenotypic Acute Leukemia (BAL).
Aim : Study incidence and subtypes of BAL, correlate with age, morphology, and cytogenetic findings and correlate the clinico-hematological data with the treatment response. St Jude′s and the EGIL′s criteria have been compared for their diagnostic and clinical relevance.
Material and Methods : Diagnosis was based on WHO classification, including clinical details, morphology, cytochemistry, immunophenotyping, and molecular genetics. We included those cases, which fulfilled the European Group for the Immunological Characterization of Acute Leukemia′s (EGIL′s) scoring system criteria for the diagnosis of BAL, as per recommendation of the WHO classification.
Results : There were 32 patients diagnosed with BAL, based on EGIL′s criteria. Incidence of BAL was 1.2%. B-Myeloid (14 cases) followed by T-Myeloid BAL (13 cases) were the commonest subtypes. Polymorphous population of blasts (16 cases) was commonly associated with T-Myeloid BAL (10 cases). BCR ABL fusion positivity was a common cytogenetic abnormality (seven cases). Fifteen patients received chemotherapy; eight achieved complete remission (CR) at the end of the induction period.
Conclusions : Pediatric BAL and T-B lymphoid BAL have a better prognosis. A comprehensive panel of reagents is required, including cytoplasmic markers; to diagnose BAL. St Jude′s criteria is a simple, easy, and cost-effective method to diagnose BAL. The outcome-related prognostic factors include age, HLA-DR, CD34 negativity, and subtype of BAL. BCR-ABL expression is an important prognostic factor, as these cases will be labeled as Chronic myeloid leukemia (CML) in blast crisis with biphenotypic expression and treated accordingly.

Biphenotypic leukemia, cytogenetics, immunophenotyping

© Copyright 2009 Indian Journal of Cancer.
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