Mixed phenotype acute leukaemia: a case report of an unusual presentation

Authors

  • Veeraraghavan Gurusamy Department of Pathology, Madras Medical College, Chennai, Tamil Nadu, India
  • Ramya Panneerselvam Department of Pathology, Madras Medical College, Chennai, Tamil Nadu, India
  • Bharathi Vidhya Jayanthi Department of Pathology, Madras Medical College, Chennai, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20173024

Keywords:

Acute leukaemia’s of ambiguous lineage, Flow cytometry, Mixed phenotype acute leukaemia, T-Lymphoid/Myeloid

Abstract

Mixed phenotype acute leukaemias (MPALs), a varied group of disorders pose a diagnostic challenge to the physicians and pathologists alike. This rare subset of acute leukaemias are characterised by the presence of blasts which express markers of more than one lineage (B-lymphoid / T-lymphoid / Myeloid lineage), making the essentiality of immunophenotyping more pertinent. MPALs are included in the acute leukaemias of ambiguous lineage under the World health organization (WHO) classification of tumours of haematopoietic and lymphoid tissues. We describe here a case report of mixed phenotype acute leukaemia (T-Lymphoid/Myeloid). 

References

Borowitz M, Bene MC, Harris NL, Porwit A, Matutes E. Acute leukaemia of ambiguous lineage. In: Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, et al., eds. World health organization classification of tumours. Pathology and Genetics of tumours of haematopoietic and lymphoid tissues. Lyon, France: IARC Press; 2008:150-155.

Mirro J, Kitchingman GR, Williams DL, Murphy SB, Zipf TF, Stass SA. Mixed lineage leukemia: the implications for hematopoietic differentiation. Blood. 1986;68(2):597-9.

Guzzini F, Angelopoulos N, Banfi L, Coppetti D, Ceppi M, Camerone G. Acute hybrid leukaemia. Review of the literature and presentation of a case. G Clin Med. 1990;71(3):195-201.

Weir EG, Ali Ansari-Lari M, Batista DA, Griffin CA, Fuller S, Smith BD, et al. Acute bilineal leukaemia: a rare disease with poor outcome. Leukaemia. 2007;21(11):2264-70.

Weinberg OK, Arber DA. Mixed-phenotype acute leukaemia: historical overview and a new definition. Leukaemia. 2010;24(11):1844-51.

Pomerantz A, Rodriguez-Rodriguez S, Demichelis-Gomez R, Barrera-Lumbreras G, Barrales-Benitez, O, Lopez-Karpovitch X, et al. Mixed-phenotype acute leukaemia: suboptimal treatment when the 2008/2016 WHO classification is used. Blood Res. 2016;51(4):233-41.

Rubnitz JE, Onciu M, Pounds S, Shurtleff S, Cao X, Raimondi SC, et al. Acute mixed lineage leukaemia in children: the experience of St. Jude children's research hospital. Blood. 2009;113(21):5083-9.

Bene MC. Biphenotypic, bilineal, ambiguous or mixed lineage: strange leukaemias! Haematologica. 2009;94(7):891-3.

Matutes E, Pickl WF, van't Veer M, Morilla R, Swansbury J, Strobl H, et al. Mixed phenotype acute leukaemia (MPAL): clinical and laboratory features and outcome in 100 patients defined according to the WHO 2008 classification. Blood. 2011;117(11):3163-71.

Dorantes-Acosta E, Pelayo R. Lineage switching in acute leukaemia: a consequence of stem cell plasticity? Bone Marrow Res. 2012;19:2012.

Ossenkoppele GJ, Van de Loosdrecht AA, Schuurhuis GJ. Review of the relevance of aberrant antigen expression by flow cytometry in myeloid neoplasms. Br J Haematol. 2011;153:421-36.

Bene MC, Castoldi G, Knapp W, Ludwig WD, Matutes E, Orfao A, et al. Proposal for the immunologic classification of acute leukaemias. Leukemia. 1995;9:1783-6.

Owaidah TM, Al Beihany A, Iqbal MA, Elkum N, Roberts GT. Cytogenetics, molecular and ultra-structural characteristics of biphenotypic acute leukaemia identified by the EGIL scoring system. Leukemia. 2006;20:620-6.

Hasle H, Alonzo TA, Auvrignon A, Behar C, Chang M, Creutzig U, et al. Monosomy 7 and deletion 7q in children and adolescents with acute myeloid leukaemia: an international retrospective study. Blood. 2007;109(11):4641-7.

Wolach O, Stone RM. How to treat mixed-phenotype acute leukaemia. Blood. 2015;125(16):2477-85.

Yan L, Ping N, Zhu M, Sun A, Xue Y, Ruan C, et al. Clinical, immunophenotypic, cytogenetic, and molecular genetic features in 117 adult patients with mixed-phenotype acute leukaemia defined by WHO-2008 classification. Haematologica. 2012;97(11):1708-12.

Kawajiri C, Tanaka H, Hashimoto S, Takeda Y, Sakai S, Takagi T, et al. Successful treatment of Philadelphia chromosome-positive mixed phenotype acute leukaemia by appropriate alternation of second-generation tyrosine kinase inhibitors according to BCR-ABL1 mutation status. Int J Hematol. 2014;99:513-8.

Downloads

Published

2017-06-24

How to Cite

Gurusamy, V., Panneerselvam, R., & Jayanthi, B. V. (2017). Mixed phenotype acute leukaemia: a case report of an unusual presentation. International Journal of Research in Medical Sciences, 5(7), 3247–3250. https://doi.org/10.18203/2320-6012.ijrms20173024

Issue

Section

Case Reports