| Objective To explore the clinical, biological and prognostic features of acute biphenotypic leukemia (BAL) in adults. Methods Sixty-three cases with BAL were diagnosed and classified with morphologic/ cytochemical, immunologic and/or cytogenetic (MIC) examinations. Patients were treated according to protocols directed to acute myeloid leukemia (AML), acute lymphoblastic leukemia (ALL) or both. Results There were no significant difference in clinical features between BAL and AML or ALL. Morphologically, M5, M, and M2 were predominant in AML, and L2, L, were predominant in ALL. Immunologically, coexpression of myeloid and B lineage associated antigens was predominant, and CD34 was highly expressed in BAL which suggested that BAL be originated from malignant transformation of earlier hematopoietic cell. Cytogenetically, Ph chromosome was seen in 25.5%( 13/51) of patients with BAL. Prognostically, patients had poor response to treatment and the overall survival was short. Conclusion Patients with BAL have unique clinical, biological and prognostic features.
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