ADULT BIPHENOTYPIC ACUTE LEUKEMIA: THE EGYPTIAN NATIONAL CANCER INSTITUTE EXPERIENCE
(Abstract release date: 05/19/16)
EHA Library. Darwish A. 06/09/16; 134566; PB1666
Prof. Amira Darwish
Contributions
Contributions
Abstract
Abstract: PB1666
Type: Publication Only
Background
Biphenotypic acute leukemia is a rare form of leukemia. Knowledge concerning the clinical and biological presentation, as well as the outcome of treatment, in adult is limited
Aims
Our objective was to analyze the biological features and outcome of patients diagnosed with BAL in our institute.
Methods
This is a retrospective analysis of the clinical, biological, and immunophenotypic features of 30 biphenotypic acute leukemias (BALs), fulfilling modified EGIL’s score, and treated in the medical oncology department at the National Cancer Institute ( NCI-Cairo) between 2005& 2010. Myeloid and T-lineage features were demonstrated by cytoplasmic myeloperoxidase and CD3; B-lineage features were demonstrated by CD19, CD22 and CD10.
Results
There were 18 men and 12 women; all were adult with a male to female ratio 3:2. The median age of the patients at diagnosis was 40 years (range, 19-62).The median white blood cell (WBC) count, hemoglobin concentration and platelet count were 31x103/dl (range, 2-275), 7g/dl (range, 4.1-11) and 53x103/dl (range, 14-539), respectively. Morphological assessment showed myeloid features in 14, and undifferentiated in sixteen patients. According to the EGIL classification, there were 20 cases of myeloid + B-lymphoid leukemia (66.7%), 5 cases of myeloid + T-lymphoid (16.7%), and 5 cases of trilineage myeloid + B + T-lymphoid leukemia (16.7%). The most common phenotypic feature was the expression of CD45 antigen which was positive in 27 (93.1%) patients. Cytogenetic results were available for only 4 patients. Eight patients received ALL-tailored therapy, 14 received AML-tailored therapy while 8 were either unfit for chemotherapy or died before induction treatment. Patients that received ALL-tailored chemotherapy had a better CR achievement rate (87.5%) over the patients that received AML-tailored chemotherapy (35.7%). The 6, 12 & 24 months overall survival (OS) were 33.3%, 30.0% & 26.6% respectively. Although patients with trilineage phenotype had better OS at 6, 12 & 24 months this was not of statistical significance.
Conclusion
Biphenotypic acute leukemia is a poor-risk disease. Despite the progress in the treatment of acute leukemia there are no uniform criteria about whether to treat BAL patients as ALL or AML. Further prospective collaborative studies are needed to investigate proper treatment protocols for this entity.
Session topic: E-poster
Keyword(s): Acute leukemia, Acute myeloid leukemia
Type: Publication Only
Background
Biphenotypic acute leukemia is a rare form of leukemia. Knowledge concerning the clinical and biological presentation, as well as the outcome of treatment, in adult is limited
Aims
Our objective was to analyze the biological features and outcome of patients diagnosed with BAL in our institute.
Methods
This is a retrospective analysis of the clinical, biological, and immunophenotypic features of 30 biphenotypic acute leukemias (BALs), fulfilling modified EGIL’s score, and treated in the medical oncology department at the National Cancer Institute ( NCI-Cairo) between 2005& 2010. Myeloid and T-lineage features were demonstrated by cytoplasmic myeloperoxidase and CD3; B-lineage features were demonstrated by CD19, CD22 and CD10.
Results
There were 18 men and 12 women; all were adult with a male to female ratio 3:2. The median age of the patients at diagnosis was 40 years (range, 19-62).The median white blood cell (WBC) count, hemoglobin concentration and platelet count were 31x103/dl (range, 2-275), 7g/dl (range, 4.1-11) and 53x103/dl (range, 14-539), respectively. Morphological assessment showed myeloid features in 14, and undifferentiated in sixteen patients. According to the EGIL classification, there were 20 cases of myeloid + B-lymphoid leukemia (66.7%), 5 cases of myeloid + T-lymphoid (16.7%), and 5 cases of trilineage myeloid + B + T-lymphoid leukemia (16.7%). The most common phenotypic feature was the expression of CD45 antigen which was positive in 27 (93.1%) patients. Cytogenetic results were available for only 4 patients. Eight patients received ALL-tailored therapy, 14 received AML-tailored therapy while 8 were either unfit for chemotherapy or died before induction treatment. Patients that received ALL-tailored chemotherapy had a better CR achievement rate (87.5%) over the patients that received AML-tailored chemotherapy (35.7%). The 6, 12 & 24 months overall survival (OS) were 33.3%, 30.0% & 26.6% respectively. Although patients with trilineage phenotype had better OS at 6, 12 & 24 months this was not of statistical significance.
Conclusion
Biphenotypic acute leukemia is a poor-risk disease. Despite the progress in the treatment of acute leukemia there are no uniform criteria about whether to treat BAL patients as ALL or AML. Further prospective collaborative studies are needed to investigate proper treatment protocols for this entity.
Session topic: E-poster
Keyword(s): Acute leukemia, Acute myeloid leukemia
Abstract: PB1666
Type: Publication Only
Background
Biphenotypic acute leukemia is a rare form of leukemia. Knowledge concerning the clinical and biological presentation, as well as the outcome of treatment, in adult is limited
Aims
Our objective was to analyze the biological features and outcome of patients diagnosed with BAL in our institute.
Methods
This is a retrospective analysis of the clinical, biological, and immunophenotypic features of 30 biphenotypic acute leukemias (BALs), fulfilling modified EGIL’s score, and treated in the medical oncology department at the National Cancer Institute ( NCI-Cairo) between 2005& 2010. Myeloid and T-lineage features were demonstrated by cytoplasmic myeloperoxidase and CD3; B-lineage features were demonstrated by CD19, CD22 and CD10.
Results
There were 18 men and 12 women; all were adult with a male to female ratio 3:2. The median age of the patients at diagnosis was 40 years (range, 19-62).The median white blood cell (WBC) count, hemoglobin concentration and platelet count were 31x103/dl (range, 2-275), 7g/dl (range, 4.1-11) and 53x103/dl (range, 14-539), respectively. Morphological assessment showed myeloid features in 14, and undifferentiated in sixteen patients. According to the EGIL classification, there were 20 cases of myeloid + B-lymphoid leukemia (66.7%), 5 cases of myeloid + T-lymphoid (16.7%), and 5 cases of trilineage myeloid + B + T-lymphoid leukemia (16.7%). The most common phenotypic feature was the expression of CD45 antigen which was positive in 27 (93.1%) patients. Cytogenetic results were available for only 4 patients. Eight patients received ALL-tailored therapy, 14 received AML-tailored therapy while 8 were either unfit for chemotherapy or died before induction treatment. Patients that received ALL-tailored chemotherapy had a better CR achievement rate (87.5%) over the patients that received AML-tailored chemotherapy (35.7%). The 6, 12 & 24 months overall survival (OS) were 33.3%, 30.0% & 26.6% respectively. Although patients with trilineage phenotype had better OS at 6, 12 & 24 months this was not of statistical significance.
Conclusion
Biphenotypic acute leukemia is a poor-risk disease. Despite the progress in the treatment of acute leukemia there are no uniform criteria about whether to treat BAL patients as ALL or AML. Further prospective collaborative studies are needed to investigate proper treatment protocols for this entity.
Session topic: E-poster
Keyword(s): Acute leukemia, Acute myeloid leukemia
Type: Publication Only
Background
Biphenotypic acute leukemia is a rare form of leukemia. Knowledge concerning the clinical and biological presentation, as well as the outcome of treatment, in adult is limited
Aims
Our objective was to analyze the biological features and outcome of patients diagnosed with BAL in our institute.
Methods
This is a retrospective analysis of the clinical, biological, and immunophenotypic features of 30 biphenotypic acute leukemias (BALs), fulfilling modified EGIL’s score, and treated in the medical oncology department at the National Cancer Institute ( NCI-Cairo) between 2005& 2010. Myeloid and T-lineage features were demonstrated by cytoplasmic myeloperoxidase and CD3; B-lineage features were demonstrated by CD19, CD22 and CD10.
Results
There were 18 men and 12 women; all were adult with a male to female ratio 3:2. The median age of the patients at diagnosis was 40 years (range, 19-62).The median white blood cell (WBC) count, hemoglobin concentration and platelet count were 31x103/dl (range, 2-275), 7g/dl (range, 4.1-11) and 53x103/dl (range, 14-539), respectively. Morphological assessment showed myeloid features in 14, and undifferentiated in sixteen patients. According to the EGIL classification, there were 20 cases of myeloid + B-lymphoid leukemia (66.7%), 5 cases of myeloid + T-lymphoid (16.7%), and 5 cases of trilineage myeloid + B + T-lymphoid leukemia (16.7%). The most common phenotypic feature was the expression of CD45 antigen which was positive in 27 (93.1%) patients. Cytogenetic results were available for only 4 patients. Eight patients received ALL-tailored therapy, 14 received AML-tailored therapy while 8 were either unfit for chemotherapy or died before induction treatment. Patients that received ALL-tailored chemotherapy had a better CR achievement rate (87.5%) over the patients that received AML-tailored chemotherapy (35.7%). The 6, 12 & 24 months overall survival (OS) were 33.3%, 30.0% & 26.6% respectively. Although patients with trilineage phenotype had better OS at 6, 12 & 24 months this was not of statistical significance.
Conclusion
Biphenotypic acute leukemia is a poor-risk disease. Despite the progress in the treatment of acute leukemia there are no uniform criteria about whether to treat BAL patients as ALL or AML. Further prospective collaborative studies are needed to investigate proper treatment protocols for this entity.
Session topic: E-poster
Keyword(s): Acute leukemia, Acute myeloid leukemia
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