Prognostic implications of the immunophenotype in biphenotypic acute leukemia

Lee, Je Hwan; Min, Yoo Hong; Chung, Chul Won; Kim, Byoung Kook; Yoon, Hwi Joong; Jo, Deog Yeon; Shin, Ho Jin; Bang, Soo Mee; Won, Jong Ho; Zang, Dae Young; Kim, Hyeoung Joon; Sook, Hyun; Lee, Kyoo Hyung; Cheong, June Won; Kim, Jin Seok; Kim, Sun Hee; Park, Wan Beom; Park, Su Yon; Chung, Joo Seop; Lee, Jae Hoon; Park, Chan Jeoung

doi:10.1080/10428190701843247

Cited by 41 publications

(30 citation statements)

References 28 publications

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“…more than 80%. 8,10 These results support the supposition that BAL may originate from stem/progenitor cells.…”

Section: Discussionsupporting

confidence: 80%

Clinical and biological characteristics of adult biphenotypic acute leukemia in comparison with that of acute myeloid leukemia and acute lymphoblastic leukemia: a case series of a Chinese population

Xu¹,

Wang²,

Lu³

et al. 2009

Haematologica

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BackgroundBiphenotypic acute leukemia is a rare disorder that is difficult to diagnose. It displays features of both myeloid and lymphoid lineage. There is still a lack of studies in biphenotypic acute leukemia in a Chinese population. We present here a comprehensive investigation of the clinical and biological characteristics, and outcome of biphenotypic acute leukemia in our hospital in over a seven year period. Design and MethodsWe retrospectively analyzed 452 adult acute leukemia patients diagnosed according to French-American-British (FAB) classification and biphenotypic acute leukemia diagnosed according to European Group for the Immunological Characterization of Leukemias (EGIL) classification, respectively. Biological characteristics, response to treatment, and outcome were examined in biphenotypic acute leukemia patients and compared with that in acute myeloid leukemia and acute lymphoblastic leukemia patients with complete follow-up profiles diagnosed in the same period. ResultsOf 452 acute leukemia patients, 21 cases (4.6%) were diagnosed as biphenotypic acute leukemia. Among them, 14 (66.7%) were B lymphoid and myeloid, 5 (23.8%) were T lymphoid and myeloid, one (4.8%) was T/B lymphoid and one (4.8%) was trilineage differentiation. When compared with acute myeloid leukemia and acute lymphoblastic leukemia, patients with biphenotypic acute leukemia showed significantly higher incidence of CD34 antigen expression, unfavorable karyotypes, and extramedullary infiltration (p<0.05). In this cohort of patients with biphenotypic acute leukemia, t(9;22) was the most common abnormality in chromosome structure. The median disease-free survival and overall survival in biphenotypic acute leukemia patients was five months and ten months, respectively, significantly shorter than those in acute myeloid leukemia and acute lymphoblastic leukemia patients (p<0.05). ConclusionsThe prognosis of biphenotypic acute leukemia patients is poor when compared with de novo acute myeloid leukemia or acute lymphoblastic leukemia. Biphenotypic acute leukemia patients showed a much higher incidence of CD34 antigen expression, complex abnormal karyotype, extramedullary infiltration, relapse, and resistance to therapy after relapse.Key words: biphenotypic leukemia, immunophenotype, cytogenetics, prognosis. Haematologica 2009;94:919-927.doi:10.3324/haematol.2008 This is an open-access paper.

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“…more than 80%. 8,10 These results support the supposition that BAL may originate from stem/progenitor cells.…”

Section: Discussionsupporting

confidence: 80%

Clinical and biological characteristics of adult biphenotypic acute leukemia in comparison with that of acute myeloid leukemia and acute lymphoblastic leukemia: a case series of a Chinese population

Xu¹,

Wang²,

Lu³

et al. 2009

Haematologica

View full text Add to dashboard Cite

show abstract

“…All of the patients with the Philadelphia chromosome were characterized by myeloid and B-lymphoid immunophenotype. 39 However, the incidence of the Philadelphia chromosome was noted to be significantly lower in pediatric biphenotypic cases, estimated at 3% in one study. 33 Rubnitz et al 38 found that most of their pediatric cases had abnormal karyotypes (29/33 in total), with the most common being abnormalities of chromosomes 5 or 7 followed by 12p abnormalities.…”

Section: Genetic Findingsmentioning

confidence: 99%

“…In their study of pediatric biphenotypic acute leukemia cases, Rubnitz et al 38 found no difference in survival between those with B/myeloid and those with T/myeloid leukemia. However, when evaluating survival by immunophenotype in an adult population, Lee et al 39 found that cases with myeloid and T-lymphoid phenotype had a worse overall survival as compared with the rest of the biphenotypic cases in a multivariate analysis. Expression of CD19 and CD14 was associated with unfavorable outcome in this study.…”

Section: Clinical Outcomementioning

confidence: 99%

“…The most common lymphoid markers included CD10 in myeloid and B-lymphoid cases and TdT in all biphenotypic cases. 39 …”

Section: Immunophenotypic Findingsmentioning

confidence: 99%

“…These authors also looked at MDR1 gene expression and found that it was higher in patients with biphenotypic acute leukemia than AML using RT-PCR and flow cytometry. Lee et al 39 studied 43 patients with biphenotypic acute leukemia and found that the Philadelphia chromosome t(9;22) was the most common abnormality, present in 14 patients (32%). All of the patients with the Philadelphia chromosome were characterized by myeloid and B-lymphoid immunophenotype.…”

Section: Genetic Findingsmentioning

confidence: 99%

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