Adult Leukemia Program, Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Suite D1B30 (Mayer 1B21), Boston, MA 02215, USA.
Hematol Oncol Clin North Am. 2011 Dec;25(6):1235-53. doi: 10.1016/j.hoc.2011.09.014.
From the standpoint of the hematopathologist, attempts to dissect the immunophenotype and other lineage-defining characteristics of the puzzling group of acute leukemias of ambiguous origin have prompted considerable discussion and debate. For clinicians, however, such definitions, although academically interesting, as yet give relatively little insight into the most appropriate therapy, and patients with MPAL continue to do poorly compared with more typical AML or ALL cases. The most recent WHO 2008 MPAL definitions are provocative, but represent a major change from the previous EGIL BAL classification, and the clinical relevance of this change has yet to be established. Only further insight from the molecular biology laboratory can help define the true cell of origin and molecular drivers of ambiguous leukemias. New molecular information will allow clinicians and pathologists to refine classification of these challenging entities, and most importantly, should permit improved treatment for patients.
从血液病理学家的角度来看，为了解剖具有模糊起源的急性白血病这一令人困惑的群体的免疫表型和其他谱系定义特征，已经引发了相当多的讨论和争论。然而，对于临床医生来说，这些定义虽然在学术上很有趣，但对于最适当的治疗方法并没有太多的了解，与更典型的 AML 或 ALL 病例相比，MPAL 患者的预后仍然较差。最近的 2008 年 WHO 对混合表型急性白血病的定义具有启发性，但与之前的 EGIL BAL 分类相比，这是一个重大变化，这种变化的临床相关性尚未确定。只有来自分子生物学实验室的进一步深入了解才能帮助确定模糊白血病的真正细胞起源和分子驱动因素。新的分子信息将使临床医生和病理学家能够对这些具有挑战性的实体进行分类，最重要的是，应该为患者提供更好的治疗。
