Clinical and laboratory features of adult biphenotypic acute leukemia.

Aim To analyze the clinical and biological characteristics of adult BAL. Methods We identified 22 cases (4.4%) of BAL from 496 newly diagnosed acute leukemia patients and compared them with patients with acute myloid leukemia (AML) and acute lymphoblastic leukemia (ALL). Results CD34 positivity was higher in BAL (87%) than in ALL (60%, P=0.04) and AML patients (63%, P=0.05). The median age in the BAL group was greater than in ALL (43 vs 31 years, P=0.04). Enlargement of liver, spleen and lymphonodes was more common in BAL (81.8%) than AML (46%, P=0.003). Cytogenetic analysis revealed abnormal karyotypes in 56% of BAL patients. The overall completed remission rate in the BAL group (65%) was lower than in ALL (86%, P=0.04). Conclusion BAL patients showed a much higher incidence of older age, CD34 antigen expression, presence of Philadelphia chromosome, liver, spleen and lymphonodes infiltration and resistance to therapy.