Mixed-phenotype acute leukemia: Flow cytometric analysis in a tertiary care center of Bangladesh.

BACKGROUND

Mixed-phenotype acute leukemia (MPAL) is a rare but difficult to treat hematologic malignancy.

METHODS

flow cytometry immunophenotyping method was used in EDTA bone marrow and/or peripheral blood taken from all consecutive morphologically diagnosed acute leukemia (AL) patients from November 2015 to December 2019.

RESULTS

Among 616 consecutive AL cases diagnosed and evaluated during this period, 22(3.57%) patients with MPAL were identified fulfilling WHO 2008 criteria for immunophenotypic characteristics of AL. Fifteen (68.2%) cases were diagnosed as B/myeloid, 5(22.72%) as T/myeloid and 2 (9.1%) as B/T MPAL. Morphologically diagnosed 15 (68.2%) AML cases were immunophenotypically B/Myeloid MPAL (12/15) and 3/15 cases were T/Myeloid MPAL. Morphologically 7 (31.8%) were ALL of which immunophenotypically 3/7 cases were B/Myeloid MPAL, 2/7 cases were T/Myeloid MPAL and 2/7 were B/T MPAL.

CONCLUSION

Multiparametric flow cytometry using comprehensive panel of monoclonal antibodies is a valuable tool to diagnose MPAL known to have a poor outcome.