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Diagnosis of biphenotypic acute leukemia: a paradigmatic approach.
Int J Clin Exp Pathol. 2009 Oct 10; 3(1):75-86.IJ

Abstract

Biphenotypic acute leukemia (BAL), or acute leukemia with a single population of blasts coexpressing markers of two different lineages, is a rare clinical entity. To define BAL, a scoring system was proposed by the European Group of Immunological Markers for Leukemias (EGIL) in 1995. However, increasing evidence suggests that this system has limitations, as acknowledged by the 2008 World Health Organization (WHO) Classification of Tumors of Hematopoietic and Lymphoid Tissues. Although substantially improved in relation to the EGIL, the new WHO Classification is still not optimal for guiding the clinical management of patients with BAL. We propose a new paradigmatic approach to defining BAL based on recent clinical studies of BAL and advances in immunologic marker definition and cytogenetics, and applied our new approach to 8 cases of "BAL" among a cohort of 742 new acute leukemias in our Cancer Center. By our new criteria, 6 cases were reclassified as acute lymphoblastic leukemia (ALL), while only 2 were still classified as BAL. Our approach is also supported by analyses of the BAL cases previously reported by other institutions.

Authors+Show Affiliations

Department of Pathology, University of Maryland School of Medicine, Marlene and Stewart Greenebaum Cancer Center, Baltimore, MD 21201, USA. xzhao@umm.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19918331

Citation

Zhao, Xianfeng Frank, et al. "Diagnosis of Biphenotypic Acute Leukemia: a Paradigmatic Approach." International Journal of Clinical and Experimental Pathology, vol. 3, no. 1, 2009, pp. 75-86.
Zhao XF, Gojo I, York T, et al. Diagnosis of biphenotypic acute leukemia: a paradigmatic approach. Int J Clin Exp Pathol. 2009;3(1):75-86.
Zhao, X. F., Gojo, I., York, T., Ning, Y., & Baer, M. R. (2009). Diagnosis of biphenotypic acute leukemia: a paradigmatic approach. International Journal of Clinical and Experimental Pathology, 3(1), 75-86.
Zhao XF, et al. Diagnosis of Biphenotypic Acute Leukemia: a Paradigmatic Approach. Int J Clin Exp Pathol. 2009 Oct 10;3(1):75-86. PubMed PMID: 19918331.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diagnosis of biphenotypic acute leukemia: a paradigmatic approach. AU - Zhao,Xianfeng Frank, AU - Gojo,Ivana, AU - York,Teresa, AU - Ning,Yi, AU - Baer,Maria R, Y1 - 2009/10/10/ PY - 2009/07/31/received PY - 2009/09/23/accepted PY - 2009/11/18/entrez PY - 2009/11/18/pubmed PY - 2010/3/3/medline KW - ALL KW - AML KW - Biphenotypic acute leukemia KW - EGIL KW - classification SP - 75 EP - 86 JF - International journal of clinical and experimental pathology JO - Int J Clin Exp Pathol VL - 3 IS - 1 N2 - Biphenotypic acute leukemia (BAL), or acute leukemia with a single population of blasts coexpressing markers of two different lineages, is a rare clinical entity. To define BAL, a scoring system was proposed by the European Group of Immunological Markers for Leukemias (EGIL) in 1995. However, increasing evidence suggests that this system has limitations, as acknowledged by the 2008 World Health Organization (WHO) Classification of Tumors of Hematopoietic and Lymphoid Tissues. Although substantially improved in relation to the EGIL, the new WHO Classification is still not optimal for guiding the clinical management of patients with BAL. We propose a new paradigmatic approach to defining BAL based on recent clinical studies of BAL and advances in immunologic marker definition and cytogenetics, and applied our new approach to 8 cases of "BAL" among a cohort of 742 new acute leukemias in our Cancer Center. By our new criteria, 6 cases were reclassified as acute lymphoblastic leukemia (ALL), while only 2 were still classified as BAL. Our approach is also supported by analyses of the BAL cases previously reported by other institutions. SN - 1936-2625 UR - https://www.unboundmedicine.com/medline/citation/19918331/Diagnosis_of_biphenotypic_acute_leukemia:_a_paradigmatic_approach_ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/19918331/ DB - PRIME DP - Unbound Medicine ER -