Biphenotypic acute leukaemia

Biphenotypic acute leukaemia (BAL) is a rare and aggressive form of acute leukaemia that exhibits characteristics of both acute lymphoblastic leukaemia (ALL) and acute myeloid leukaemia (AML). This dual lineage expression makes it a unique and challenging condition to diagnose and treat.

Classification

Biphenotypic acute leukaemia is classified under the broader category of acute leukaemias. It is identified based on the expression of specific markers that are typically associated with both lymphoid and myeloid lineages. The World Health Organization (WHO) classification system includes BAL under the category of mixed phenotype acute leukaemia (MPAL).

Diagnosis

The diagnosis of BAL involves a combination of morphology, immunophenotyping, cytogenetics, and molecular genetics. Immunophenotyping is crucial for identifying the presence of both lymphoid and myeloid markers on the leukaemic cells. Common markers include CD19, CD10, CD79a for the lymphoid lineage, and CD13, CD33, myeloperoxidase (MPO) for the myeloid lineage.

Symptoms

The symptoms of biphenotypic acute leukaemia are similar to those of other types of acute leukaemia and may include:

• Fatigue
• Fever
• Frequent infections
• Easy bruising or bleeding
• Bone pain
• Swollen lymph nodes
• Pallor

Treatment

Treatment for BAL typically involves a combination of therapies used for both ALL and AML. This may include:

• Chemotherapy
• Targeted therapy
• Stem cell transplantation
• Immunotherapy

The choice of treatment depends on various factors, including the patient's age, overall health, and specific genetic abnormalities present in the leukaemic cells.

Prognosis

The prognosis for patients with biphenotypic acute leukaemia is generally poor compared to those with either ALL or AML alone. The dual lineage nature of the disease often makes it more resistant to standard treatments. However, advancements in targeted therapies and personalized medicine are providing new hope for improved outcomes.

Research

Ongoing research is focused on better understanding the genetic and molecular mechanisms underlying BAL, as well as developing more effective and targeted treatment strategies. Clinical trials are an important aspect of this research, offering patients access to new and potentially more effective therapies.

See also

• Acute lymphoblastic leukaemia
• Acute myeloid leukaemia
• Mixed phenotype acute leukaemia
• Leukaemia
• Stem cell transplantation