What is hybrid acute leukemia

Maitreyan, V.; Gale, Robert Peter

doi:10.1016/0145-2126(89)90084-2

Cited by 13 publications

(2 citation statements)

References 23 publications

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“…This widely variably incidence range cannot be rationally explained solely on the basis of clinical variability between different population groups. Indeed, this variability along with the lack of consensus as to clinical or biological significance of biphenotypia in acute leukaemia is undoubtedly due to several contributing factors: the use of inconsistent and variable diagnostic criteria, the inevitable (but frequently ignored) subjectiveness of immunophenotypic interpretation, and the lack of a standardized and uniform panel of monclonal antibodies utilized in immunophenotypic analyses (Gale & Ben-Bassat, 1987: Maitreyan & Gale, 1989. The lack of an accepted, standardized, and reproducible method of immunophenotypic analysis and the subjectiveness of flow cytometric interpretation are probably the biggest contributors to the inconsistency of diagnosing biphenotypia.…”

Section: Discussionmentioning

confidence: 99%

Acute biphenotypic leukaemia: immunophenotypic and cytogenetic analysis

et al. 1993

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The incidence of acute biphenotypic leukaemia has ranged from less than 1% to almost 50% in various reports in the literature. This wide variability may be attributed to a number of reasons including lack of consistent diagnostic criteria, use of various panels of antibodies, and the failure to recognize the lack of lineage specificity of some of the antibodies used. The morphology, cytochemistry, immunophenotype and cytogenetics of acute biphenotypic leukaemias from our institution were studied. The diagnostic criteria took into consideration the morphology of the analysed cells, light scatter characteristics, and evaluation of antibody fluorescence histograms in determining whether the aberrant marker expression was arising from leukaemic blasts or differentiated bone marrow elements. Fifty-two of 746 cases (7%) fulfilled our criteria for acute biphenotypic leukaemias. These included 30 cases of acute lymphoblastic leukaemia (ALL) expressing myeloid antigens, 21 cases of acute myelogenous leukaemia (AML) expressing lymphoid markers, and one case of ALL expressing both B- and T-cell associated antigens. The acute biphenotypic leukaemia cases consisted of four major immunophenotypic subgroups: CD2+ AML (11), CD19+ AML (8), CD13 and/or CD33+ ALL (24), CD11b+ ALL (5) and others (4). Chromosomal analysis was carried out in 42/52 of the acute biphenotypic leukaemia cases; a clonal abnormality was found in 31 of these 42 cases. This study highlights the problems encountered in the diagnosis of acute biphenotypic leukaemia, some of which may be responsible for the wide variation in the reported incidence of this leukaemia. We suggest that the use of strict, uniform diagnostic criteria may help in establishing a more consistent approach towards diagnosis of this leukaemic entity. We also suggest that biphenotypic leukaemia is comprised of biologically different groups of leukaemia based on immunophenotypic and cytogenetic findings.

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Section: Discussionmentioning

confidence: 99%

Acute biphenotypic leukaemia: immunophenotypic and cytogenetic analysis

et al. 1993

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“…Clonality, by means of DNA content, appears reasonable with respect to the granulocytes and monocytes, due to the findings of DNA hyperdiploid granulocytes in a few patients; however, DNA hypodiploid "lymphocytes" might represent small blasts or stem cells of unknown origin developed by genetic instability [18,19]. A link to hybrid leukemia [12,44] may also be possible. Another possibility is that these cells could represent lymphoid stem cells that could result in subsequent transformation to acute lymphoblastic leukemia [9].…”

Section: Discussionmentioning

confidence: 99%

DNA content of granulocytes, monocytes, and lymphocytes in the bone marrow smears of patients with myelodysplastic syndromes

et al. 2001

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Recently, we have reported a high incidence of DNA hypodiploidy defined as DNA index (DI) in blasts/promyelocytes from 39 patients with myelodysplastic syndromes (MDS) found to be without a relationship to cytogenetics. In the present study the DNA content (DI) in granulocytes, monocytes, and lymphocytes measured in the same bone marrow smears from the above patients are reported. DNA hypodiploidy was found in mature cells, not only in myeloid cells (granulocytes and monocytes) but also in lymphocytes. A lower mean DI in each cell type of patients compared to controls was found. Pairwise comparison of the mean DI (±SE) in 32 patients with normal (n = 22) and abnormal (n = 10) cytogenetics and controls (n = 8) showed a significantly (P < 0.01) lower value for each group of patients, respectively, in all cell types. No difference was found between the two groups of patients. Presence of weak-Feulgen stained nuclei (DI < 0.40) in granulocytes and monocytes was more pronounced in patients expressing DNA hypodiploid immature cell populations, but only occasionally in lymphocytes, suggesting a link to an apoptotic event and intramedullary cell death. DNA hypodiploidy is shown to be a common feature even in mature cell populations in MDS bone marrows. Clonality, by means of DNA content, appears reasonable as regards the granulocytes and monocytes. DNA hypodiploid lymphocytes, on the other hand, might be small blasts (stem cells) or dying cell populations of unknown origin. Am.

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Comparison of acute myeloid leukemia occurring de novo or preceded by a myelodysplastic stage: Differences in cellular DNA content

et al. 1993

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The DNA content of bone marrow cells in patients with acute leukemia preceded by a myelodysplastic stage (MDS-AML) was compared to that in patients with de novo AML. We studied granulocytes, lymphocytes, monocytes, and blasts/promyelocytes from Feulgen-stained bone marrow smears of 11 patients with de novo AML, ten patients with MDS-AML, and 13 apparently healthy controls. The mean amount of DNA per cell (DNA index; DI) in each cell population was determined using a digital video-based image-analyzing system (CAS-100). Analysis of variance (F test) showed a significant difference in the DNA content between de novo AML on one hand and MDS-AML and controls on the other as regards to blasts/promyelocytes (P < 0.01), lymphocytes (P < 0.05), and monocytes (P < 0.01), respectively. In three of 11 (27%) patients with de novo AML, a lower than normal limit DI was found both in immature and mature bone marrow cells. Patients with MDS-AML had those of DI values similar to normal controls. In consequence, a significantly reduced mean DI was found in patients with de novo AML in blasts/promyelocytes (P < 0.01), and monocytes (P < 0.05) compared to both normal controls and MDS-AML. Together with data published separately, suggesting differences in granulocyte morphology, clonality, and HLA-DR expression, these data suggest biological differences between the two diseases.

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What is hybrid acute leukemia

Cited by 13 publications

References 23 publications

Acute biphenotypic leukaemia: immunophenotypic and cytogenetic analysis

Acute biphenotypic leukaemia: immunophenotypic and cytogenetic analysis

DNA content of granulocytes, monocytes, and lymphocytes in the bone marrow smears of patients with myelodysplastic syndromes

Comparison of acute myeloid leukemia occurring de novo or preceded by a myelodysplastic stage: Differences in cellular DNA content

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