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Year : 2009  |  Volume : 46  |  Issue : 2  |  Page : 160--168

Clinico-hematological profile in biphenotypic acute leukemia

S Gujral1, S Polampalli2, Y Badrinath1, A Kumar1, A Chogule2, PG Subramanian1, G Raje3, P Amare3, B Arora4, SD Banavali4, CN Nair4 
1 Hematopathology Laboratory, Tata Memorial Hospital (TMH), Mumbai, India
2 Molecular Hematology Laboratory, Tata Memorial Hospital (TMH), Mumbai, India
3 Cancer cytogenetics Laboratory, Tata Memorial Hospital (TMH), Mumbai, India
4 Department of Medical Oncology, Tata Memorial Hospital (TMH), Mumbai, India

Correspondence Address:
S Gujral
Hematopathology Laboratory, Tata Memorial Hospital (TMH), Mumbai
India

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俟Q製 and the EGIL俟Q製 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俟Q製 (EGIL俟Q製) 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俟Q製 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俟Q製 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.


How to cite this article:
Gujral S, Polampalli S, Badrinath Y, Kumar A, Chogule A, Subramanian P G, Raje G, Amare P, Arora B, Banavali S D, Nair C N. Clinico-hematological profile in biphenotypic acute leukemia.Indian J Cancer 2009;46:160-168


How to cite this URL:
Gujral S, Polampalli S, Badrinath Y, Kumar A, Chogule A, Subramanian P G, Raje G, Amare P, Arora B, Banavali S D, Nair C N. Clinico-hematological profile in biphenotypic acute leukemia. Indian J Cancer [serial online] 2009 [cited 2022 Aug 17 ];46:160-168
Available from: https://www.indianjcancer.com/article.asp?issn=0019-509X;year=2009;volume=46;issue=2;spage=160;epage=168;aulast=Gujral;type=0