title: Mixed phenotypic acute leukemia with two immunophenotypically distinct blast populations: report of an unusual case.
abstract: Mixed phenotypic acute leukemia (MPAL) is a rare disorder with an incidence of less than 2% of all acute leukemia using the recent 2008 WHO criteria. Common subtypes encountered are the B/myeloid and T/myeloid; B/T or trilineage MPAL being an exception. We discuss here a case of 20-year-male patient who presented with pallor and generalised lymphadenopathy. Peripheral blood smear examination showed presence of 61% blasts of lymphoid morphology. Immunophenotyping by multicolor flow cytometry showed two distinct populations of blasts with T and B phenotype respectively. He was diagnosed as MPAL with two distinct blast lineages. Conventional karyotyping done on bone marrow sample showed t(9;22)(q34;q11)(Ph +). Induction was started using ALL based protocol. The patient is on follow up with post induction marrow being in morphological remission.
authors.affiliation: Department of Pathology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India. drkhaliq81@gmail.com
authors.forename: Khaliqur
authors.initials: K
authors.lastname: Rahman
authors.forename: Seena
authors.initials: S
authors.lastname: George
authors.forename: Apoorvi
authors.initials: A
authors.lastname: Tewari
authors.forename: Anurag
authors.initials: A
authors.lastname: Mehta
mesh_terms: D000208:Acute Disease; D001402:B-Lymphocytes / Q000473:pathology*; D001854:Bone Marrow Cells / Q000473:pathology*; D005434:Flow Cytometry; D006801:Humans; D016130:Immunophenotyping; D007621:Karyotyping; D015456:Leukemia, Biphenotypic, Acute / Q000175:diagnosis / Q000235:genetics / Q000473:pathology*; D008297:Male; D013601:T-Lymphocytes / Q000473:pathology*; D014178:Translocation, Genetic; D055815:Young Adult