Clinical characteristics and immunophenotypes of mixed-lineage acute leukemia.
- Author:
Xiao-Ling LI
1
;
Rui LI
;
Yan CHEN
Author Information
1. Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
- Publication Type:Journal Article
- MeSH:
Adolescent;
Adult;
Antigens, CD34;
analysis;
Antineoplastic Combined Chemotherapy Protocols;
therapeutic use;
Child;
Female;
Humans;
Immunophenotyping;
Karyotyping;
Leukemia, Biphenotypic, Acute;
drug therapy;
immunology;
pathology;
Male;
Middle Aged;
Philadelphia Chromosome;
Prognosis;
Retrospective Studies;
Young Adult
- From:
Journal of Experimental Hematology
2007;15(3):636-639
- CountryChina
- Language:Chinese
-
Abstract:
The aim of study was to analyze the clinical, biological features, treatment outcome and prognosis of mixed-lineage acute leukemia (MAL). 48 MAL patients diagnosed according to European Group of International Leukemia (EGIL) scoring system were retrospectively analyzed and the analysis results were compared with that from 68 cases of AML and 61 cases of ALL. The results showed that the incidence of MAL in acute leukemia was 9.6%. Morphologically, the subtypes of M(1) and M(2) were predominant in AML, while L(2) in ALL. The median of white blood cell count in MAL was significantly higher than that of non-mixed-lineage cases (AML and ALL) observed during the same period (P < 0.05). The incidences of enlargement of liver, spleen and lymphonodes in MAL were higher than those in AML. The difference was significant (P < 0.01) and was not significant compared with those in ALL (P > 0.05). Coexpression of myeloid and B lymphoid antigens in MAL patients was predominant, its rate was 70.9%. The coexpression rate of T lymphoid and myeloid antigens was 20.8%, coexpression of B, T lymphoid and myeloid antigens was 8.3%. CD34 was expressed in 79.2% of MAL cases, it was higher than those expressed in AML (54.4%) and ALL (52.5%) (P < 0.01), which suggests that MAL might originate from malignant transformation of hematopoietic stem cells. Cytogenetic analysis revealed normal and abnormal karyotypes in 32.1% and 67.9% of MAL cases respectively. In MAL Ph chromosome abnormality incidence was 25% and was significantly higher than that in AML group (0%) (P < 0.01), but was not statistical defference with that in ALL group (16.7%) (P > 0.05). The completed remission rate of MAL was 38.1%, lower than CR rate in AML (70.8%) and ALL (72.2%) respectively (P < 0.01). Treatment outcomes were negatively related to the expression of CD34 antigen and Ph chromosome. It is concluded that MAL is supposed to be originated from stem cells, coexpression of lymphoid/myeloid antigens is the major feature of MAL which accompanies many poor prognosis factors and lower CR rate. Appropriate chemotherapeutic strategy should be further searched.
