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Clinical and Experimental Medicine

, Volume 18, Issue 4, pp 513–521 | Cite as

Mixed-phenotype acute leukemia characteristics: first report from Iran

  • Behzad Poopak
  • Adnan Khosravi
  • Gholamreza Bahoush-Mehdiabadi
  • Tahereh Madani
  • Elahe Khodadi
  • Zohreh Farahani
  • Amir Ali Vahedi
  • Gelareh Khosravipour
  • Peyvand Poopak
  • Amir Hossein Poopak
Original Article
  • 62 Downloads

Abstract

Mixed-phenotype acute leukemia (MPAL) is the infrequent type of acute leukemia characterized by immunophenotypic and/or cytochemical features of both lineages, but the diagnosis of this disease still is a challenge. In this study, we analyzed immunophenotyping, cytochemistry and frequency of MPAL patients to better diagnosis of MPAL characteristics according to WHO 2016 criteria for the first time in Iran. In this retrospective study, 27 patients were diagnosed as MPAL based on WHO 2016 criteria during 2014–2017. Flow cytometric immunophenotyping was performed on PB and BM samples evaluation of different CD marker expressions in MPAL subsets. RT-PCR was performed for the analyses of BCR/ABL1 fusion in MPAL subsets. Among 27 cases, (70.4%) 19 cases were B + My, (22.22%) 6 cases were T + My, and 2 cases (7.40%) were B + T + My. CD34, CD19, HLA-DR, TdT, CD22, iMPO were positive in majority of B + My cases. CD45, iMPO, iCD3, CD7, CD2 and CD5 were positive in majority of T + My cases. HLA-DR, TdT, CD10, CD22, iCD79a, iMPO, CD45, iCD3, CD7, CD3, CD2, CD5 were positive in majority of B + T + My cases. BCR/ABL1 fusion was positive for 3 cases (11.1%) of p190 fusion and 2 cases (7.4%) of p210 fusion in B + My cases. WHO 2016 criteria are the current standard for diagnosing MPAL. Also, evaluation of TdT, CD2, CD5, CD7 expressions by flow cytometry in EGIL criteria is useful for the better diagnosis of MPAL subsets. In addition, evaluation of BCR/ABL1 and MLL rearrangements in patients should be part of standard work-up in MPAL.

Keywords

Mixed-phenotype acute leukemia Flow cytometry BCR/ABL1 

Notes

Acknowledgements

This work was financially supported by Payvand Clinical and Specialty Laboratory, Tehran, Iran.

Authors’ contributions

BP conceived the manuscript and revised it. EK, GK and PP wrote the manuscript; AHE provided clinical data and pathological diagnoses; TM, ZF, AAV and AHP performed the technical tests.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Human and animal rights

All the procedures performed in the studies involving human participants were in accordance with the ethical standards of 1964 Helsinki Declaration.

Informed consent

Written informed consent was obtained from all patients and normal subjects.

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Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  • Behzad Poopak
    • 1
    • 2
  • Adnan Khosravi
    • 3
  • Gholamreza Bahoush-Mehdiabadi
    • 4
  • Tahereh Madani
    • 2
  • Elahe Khodadi
    • 2
  • Zohreh Farahani
    • 2
  • Amir Ali Vahedi
    • 2
  • Gelareh Khosravipour
    • 2
  • Peyvand Poopak
    • 2
  • Amir Hossein Poopak
    • 2
  1. 1.Islamic Azad University, Tehran Medical Sciences BranchTehranIran
  2. 2.Payvand Clinical and Specialty LaboratoryTehranIran
  3. 3.Department of Pediatrics, Ali Asghar Pediatric HospitalIran University of Medical SciencesTehranIran
  4. 4.Tobacco Prevention and Control Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD)Shahid Beheshti University of Medical SciencesTehranIran

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