Publication

Abstract : Introduction Leukemias are characterized by an idiopathic proliferation of a progenitor cell that is committed to a single cell lineage. The diagnosis of acute leukemias (AL) relies both on clinical features and an array of multidisciplinary approaches including morphology, immunophenotyping, cytogenetic and molecular investigations. A minority of acute leukemias have features characteristic of both the myeloid and lymphoid lineages and for this reason are designated mixed-lineage, hybrid or biphenotypic acute leukemias (BAL). Material and Method Five cases diagnosed as acute leukemia showing biphenotypic morphology were studied for clinical presentation. Heamatological parameters, bone marrow examination and fl owcytometery for immunophenotyping was carried out. Five cases of leukemia with dual lineage differentiation are being described here. Results Peripheral smear & bone marrow morphological study revealed two types of blasts.Immunophenotyping done by fl ow cytometry showed expression of both myeloid and lymphoid cell markers with a score of >2 in each of the lineages. Conclusion Biphenotypic acute leukemia is an uncommon type of leukemia which probably arises in a multipotent progenitor cell with the capability of differentiating along both myeloid and lymphoid lineages.The Criteria for the diagnosis of BAL is based on scoring system adopted by European Group Of Immunological Classifi cation of Leukemia (EGIL).The scoring system distinguishes BAL from leukemias with aberrant expression.