Charles Nathan J, Boyer Daniel F
From the Department of Pathology, The University of Michigan, Ann Arbor.
Arch Pathol Lab Med. 2017 Nov;141(11):1462-1468. doi: 10.5858/arpa.2017-0218-RA.
Mixed-phenotype acute leukemia (MPAL) is a heterogeneous category in the World Health Organization classification that comprises acute leukemias with discrete admixed populations of myeloid and lymphoid blasts ("bilineal") or with extensive coexpression of lymphoid and myeloid markers in a single blast population ("biphenotypic"). Flow cytometric findings suggestive of MPAL are often met with consternation by pathologists and oncologists alike, owing to unfamiliarity with the disease and uncertainty about how MPAL fits into established paradigms for treatment of acute leukemia. The purpose of this review is to explain the diagnostic criteria for MPAL, summarize its biological and clinical features, and address common diagnostic pitfalls of these unusual leukemias.
混合表型急性白血病（MPAL）是世界卫生组织分类中的一个异质性类别，包括具有离散混合的髓系和淋巴系原始细胞群（“双系”）的急性白血病，或在单个原始细胞群中广泛共表达淋巴系和髓系标志物的急性白血病（“双表型”）。由于对该疾病不熟悉，以及对于MPAL如何适应既定的急性白血病治疗模式存在不确定性，流式细胞术提示MPAL的结果往往会让病理学家和肿瘤学家都感到困惑。本综述的目的是解释MPAL的诊断标准，总结其生物学和临床特征，并探讨这些不常见白血病常见的诊断陷阱。
