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2020, Number 3

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Rev Cubana Hematol Inmunol Hemoter 2020; 36 (3)

Diagnosis, classification and treatment of acute leukemia of ambiguous lineage

Marsán SV, Díaz DG, Triana MY

Language: Spanish
References: 18
Page:
PDF size: 586.98 Kb.


ABSTRACT

Introduction: Acute leukemias of ambiguous lineage constitute a heterogeneous group of acute leukemias that do not show clear evidence of differentiation along cell lineage. The definitive diagnosis is made exclusively based on immunophenotypic characteristics, with the use of multiparametric flow cytometry.
Objective: To update the diagnostic criteria, classification, as well as the clinical and therapeutic management of acute leukemias of ambiguous lineage.
Methods: A search for scientific information related to the subject was carried out in clinical hematology textbooks and in articles published through PUBMED in the last ten years. An analysis and summary of the revised bibliography was carried out.
Information analysis and synthesis: The morphological characteristics of the leukemic cells from patients with acute leukemia of ambiguous lineage do not show uniformity. Blasts of different sizes and stages of maturation can be found simultaneously. These may appear as lymphoid, myeloid, undifferentiated, or mixed.
Conclusion: Acute leukemias of ambiguous lineage constitute a high-risk subgroup, with unfavorable prognosis and poor overall patient survival. Its timely report is essential to gather criteria for making therapeutic decisions in this group of patients.


REFERENCES

  1. Singh N, Kumar D, Agrawal N, Panaych A, Mehta A. Diagnostic Dilemma in Ambiguous Lineage Acute Leukemia: A Case Report. Indian J Hematol Blood Transfus. 2018;34(1):178-80. .

  2. Porwit A, Bene MC. Multiparameter Flow Cytometry Applications in the Diagnosis of Mixed Phenotype Acute Leukemia. Cytometry Part B (Clinical Cytometry). 2019;968:183-94. .

  3. Johansson U, Bloxham D, Couzens S, Jesson J, Morilla R, Erber W, et al. Guidelines on the use of multicolour flow cytometry in the diagnosis of haematological neo-plasms. British Committee for Standards in Haematology. Br J Haematol. 2014;165:455-8. .

  4. Bene MC, Castoldi G, Knapp W, Ludwig WD, Matutes E, Orfao A, et al. Proposals for the immunological classification of acute leukemias. Leukemia. 1995;9(10):1783-6. .

  5. Arber D, Orazi A, Hasserjian R, Thiele J, Borowitz J, Le Beau M, et al. The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia. The update Who Classification of hematological of myeloid neoplasms and leukemia. Blood. 2016;127(20):2391-405. .

  6. Derwich K, Sedek L, Meyer C, Pieczonka A, Dawidowska M, Gaworczyk A, et al. Infant acute bilineal leukemia. Leukemia Research. 2009;33:1005-8. .

  7. Khan M, Siddiqi R, Naqvi K. An update on classification, genetics, and clinical approach to mixed phenotype acute leukemia (MPAL). Annals of Hematology. 2018;97:945-53. .

  8. Charles N, Boyer D. Mixed-Phenotype Acute. Arch Pathol Lab Med. 2017;141:1464. .

  9. Wang P, Peng X, Dean X, Gao L, Zhang X, Feng Y. Diagnostic challenges in T-cell lymphoblastic lymphoma, early T-cell precursor acute lymphoblastic leukemia or mixed phenotype acute leukemia. Medicine. 2018;97:1-5. .

  10. Gyung H, Jo H, Sung H, Min S, Ju T, Kook H. Biphenotypic acute leukemia or acute leukemia of ambiguous lineage in childhood: clinical characteristics and outcome. Blood Res. 2019;54:63-73. .

  11. Monabati A, Safaei A, Nouri S, Moeinadin S, Solhjoo F. A rare Case of Extramedullary T/Myeloid Mixed Phenotype Acute Leukemia with t(1;5)(q23;q33). Case Reports in Pathology. 2016:1-3. .

  12. Moraveji S, Torabi A, Nahleh Z, Farrag S, Gaur S. Acute leukemia of ambiguous lineage with trisomy 4 as the sole cytogenetic abnormality: A case report and literature review. Leukemia Research Reports. 2014:33-5. .

  13. Rigvardhan J, Ganguli P, Ahmed R, Sharma A, Singh J. Mixed phenotype acute leukemia of t/myeloid type with rare multiple cytogenetic abnormality of chromosome 8, 9, 11, 12, 16 and marker chromosome and dual blast population: a rare case. Medico Research Chronicles. 2015;2(3):394-8. .

  14. Gajendra S, Sachdev R, Dorwal P, Goel S, Jha B, Sahni T. Mixed-phenotypic acute leukemia: cytochemically myeloid and phenotypically early T-cell precursor acute lymphoblastic leukemia. Blood Research. 2014;49(3):196-7. .

  15. Deffis M, Alvarado M, Ruiz G, Rosas A, Barrera G, Aguayo A, et al. Diagnosing and treating mixed phenotype acute leukemia: a multicenter 10-year experience in México. Ann Hematol. 2014;93:595-601. .

  16. Rohrlich P. The cells are ambiguous, not the message. Blood 2018;132(3): 239-40. .

  17. Hrusak O, de Haas V, Stancikova J, Vakrmanova B, Janotova I, Mejstrikova E, et al. International cooperative study identifies treatment strategy in childhood ambiguous lineage leukemia. Blood. 2018;132(3):264-76. .

  18. Porwit A, Bene MC. Acute Leukemias of Ambiguos Origen. Am J Clin Pathol. 2015;144:361-76.




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