Morphological characteristics of Philadelphia chromosome-positive mixed phenotype acute leukemia

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  • フィラデルフィア染色体陽性混合型急性白血病の形態学的特徴

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<p>Although it is relatively easy to diagnose mixed- phenotype acute leukemia (MPAL) by flow cytometry, morphological findings for effective differentiation of MPAL from acute myeloid leukemia (AML) are unknown. Here, we analyze the morphological characteristics of Philadelphia chromosome (Ph)-positive MPAL, which tends to have biphenotypic or bilineal markers. A 60-year-old female with high fever and purpura was admitted to our hospital. She suffered from anemia and thrombocytopenia, and blast cells were found in her peripheral blood. Bone marrow examination revealed small lymphoid and large blasts with few granules, and the blasts were weakly positive (6%) for myeloperoxidase (MPO) and were categorized as M1 (French-American-British Classification; FAB Classification). Such blasts had dual myeloid (CD13 and 40% MPO) and B lymphoid (CD19 and CD79a) markers, as determined by FCM and had minor BCR-ABL, as determined by real-time PCR analysis. Therefore, she was diagnosed as having Ph+MPAL. Mixed small and large blasts including a small number of MPO+ cells appeared to be characteristic of Ph+MPAL.</p>

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