Study On The Clinical And Laboratorial Features Of Biphenotypic Acute Leukemia

Objective:To analyze the clinical and laboratorial features of biphenotypic acute leukemia(BAL),and assess the clinical significance between the bi?immunophenotypic leukemia and associated-therapeutic factors as well as prognosis.The study was to investigate the diagnosis and treatment of BAL according to MCIM (morphological,Immunological,cytogenetic classification and molecular biology)classification.Methods:From April 2000 to December 2005,400 cases of Acute leukemia(AL) were newly diagnosed with morphological,Immunological,cytogenetic classification and molecular biology(MICM),Immunophenotypes were all examined by flow cytometry.30 cases of BAL were diagnosed according to EGIL scoring system,compared with 90 cases acute myelocytic leukemia(AML) and 60 cases acute lymphocytic leukemia(ALL) during their corresponding period. Result:BAL was 7.5% in Acute leukemia.There were no significant differences at clinical presentation between thirty BAL patients and the cases of AML/ALL during the same period(P>0.05).P170 and CD34 were expressed in 62.0% and 73.3% of the BAL cases, respectively. BAL had significantly higher expression rates of CD34 and P170 than those of non-biphenotypic cases observed ( P < 0.05). Of the thirty patients whose immunophenotypes were examined,18 were B-Ly+/My+ phenotype, 10 were T-Ly+/My+ phenotype and 2 were T+B-Ly+ phenotype. Of the twenty BAL cases whose chromosomes were analysized, 11 patients of abnormal chromosome were expressed in 55% of the BAL cases(P<0.01). In the 28 cases treated, the complete remissiom(CR) rate was 35.7%, one year overall survival(OS) rate was 10.7%. 9 cases reached CR with the regimen involved both myeloid and lymphoid lineage. The disease free survivals(DFS) were 7 months.Conclusion:The study povided evidence that BAL had a poor treatment outcome and short survival. It had a lot of poor prognostic factors compared with those of non-biphenotypic cases. Of the twenty BAL cases whose chromosomes were analysized, 11 cases expressed abnormal chromosomes, the six cases expressed Philadelpic chromosomes. BAL patients who treated combined chemotherapy targeted to both myeloid and lymphocytic leukemia achieved good treatment outcome.