Biphenotypic acute leukemia in adults

L. E. Sulak, C. N. Clare, B. A. Morale, K. L. Hansen, M. M. Montiel

Research output: Contribution to journalArticlepeer-review

34 Scopus citations


Leukemias are characterized by an idiopathic proliferation of a progenitor cell that is committed to a single cell lineage. However, leukemias with dual-lineage differentiation are being described, especially within the pediatric age group. The authors reviewed 118 cases of adult acute leukemia phenotyped by immunofluorescent flow cytometry; 7 cases demonstrated mixed cell lineage. Immunophenotypically these cases were defined by early B-lymphocyte differentiation (TdT, HLA-DR, and CD19) coexpressed with a myeloid receptor (CD13, CD15, or CD33) on the same leukemic cell. Routine cytochemical evaluation demonstrated punctate positivity of the blasts with naphthol AS-D chloracetate esterase stain in five of seven cases. Cytogenetic analysis revealed structural abnormalities of chromosome 11 in four of the seven cases. Three of these studies showed a break at 11q23-24, the location of the human proto-oncogene ets-1. Clinically, two of these leukemias represented chronic myelogenous leukemia in blast crisis, and all cases behaved aggressively. The authors' data suggest that mixed lineage leukemias are an identifiable subset of adult acute leukemias and are associated with a poor prognosis.

Original languageEnglish (US)
Pages (from-to)54-58
Number of pages5
JournalAmerican journal of clinical pathology
Issue number1
StatePublished - 1990


  • Acute leukemia
  • Biphenotypic
  • Cytochemistry
  • Cytogenetics
  • Flow cytometry
  • Mixed lineage

ASJC Scopus subject areas

  • Pathology and Forensic Medicine


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