Indian Journal of Pathology and Microbiology

ORIGINAL ARTICLE
Year
: 2017  |  Volume : 60  |  Issue : 1  |  Page : 43--49

Mixed-phenotypic acute leukemia series from tertiary care center


Ravikiran N Pawar1, Sambhunath Banerjee1, Subhajit Bramha1, Shekhar Krishnan2, Arpita Bhattacharya2, Vaskar Saha2, Anupam Chakrapani3, Saurabh Bhave3, Mammen Chandy3, Reena Nair3, Mayur Parihar4, Neeraj Arora1, DK Mishra1 
1 Department of Laboratory Haematology and Molecular Genetics, Tata Medical Centre, Kolkata, West Bengal, India
2 Department of Clinical Haematology, Tata Medical Centre, Kolkata, West Bengal, India
3 Department of Pediatric Oncology, Tata Medical Centre, Kolkata, West Bengal, India
4 Department of Laboratory Haematology and Cytognetics, Tata Medical Centre, Kolkata, West Bengal, India

Correspondence Address:
Dr Neeraj Arora
Department of Laboratory Haematology and Molecular Genetics, Tata Medical Centre, Kolkata, West Bengal
India

Introduction: Mixed-phenotype acute leukemias (MPALs) are a heterogeneous group of rare leukemias constituting approximately 2%–5% of all leukemias, in which assigning a single lineage of origin is not possible. They are diagnosed by either the presence of antigens of more than one lineage or by the presence of dual population of blasts belonging to two or more lineages. We highlight the clinicopathological, immunophenotype, and genetic data of a cohort (n = 14) of patients diagnosed and treated at our center. Materials and Methods: We retrospectively analyzed consecutive cases of MPAL diagnosed in our flow cytometry laboratory from May 2012 to August 2015. These cases were diagnosed based on immunophenotyping of peripheral blood/bone marrow aspirates and morphology/genetics wherever available as per the World Health Organization (WHO) 2008 guideline. Results: Among 628 consecutive acute leukemia (AL) cases diagnosed and evaluated during this period, we identified 14 (2.2%) patients with MPAL fulfilling WHO 2008/EGIL criteria for immunological characterizing of AL criteria. Majority of these were males (n = 8, male:female ratio 1.3:1) and adults (n = 11, 78.5%). The median age of this cohort was 41 years (range 2–80). These cases were further classified as: B/myeloid (n = 9), T/myeloid (n = 4), and B/T MPAL (n = 1). Cytogenetics was available in 12 out of 14 cases, out of which, three cases had normal karyotype, three with t(9;22)(q34;q11), and two cases with complex karyotype. We also came across a rare case of B + T lymphoid MPAL who had mixed-lineage leukemia gene t(v; 11q23) rearrangement. Conclusion: MPAL is a complex entity with heterogeneous clinical, immunophenotypic, cytogenetic, and molecular features. Multiparametric flowcytometry by using comprehensive antibody panels is a valuable tool for diagnosis. Subsequent cytogenetic and molecular analysis for further prognostic stratification and treatment modalities are important.


How to cite this article:
Pawar RN, Banerjee S, Bramha S, Krishnan S, Bhattacharya A, Saha V, Chakrapani A, Bhave S, Chandy M, Nair R, Parihar M, Arora N, Mishra D K. Mixed-phenotypic acute leukemia series from tertiary care center.Indian J Pathol Microbiol 2017;60:43-49


How to cite this URL:
Pawar RN, Banerjee S, Bramha S, Krishnan S, Bhattacharya A, Saha V, Chakrapani A, Bhave S, Chandy M, Nair R, Parihar M, Arora N, Mishra D K. Mixed-phenotypic acute leukemia series from tertiary care center. Indian J Pathol Microbiol [serial online] 2017 [cited 2020 Aug 12 ];60:43-49
Available from: http://www.ijpmonline.org/article.asp?issn=0377-4929;year=2017;volume=60;issue=1;spage=43;epage=49;aulast=Pawar;type=0