Mixed-phenotype acute leukemia (MPAL) is a group of blood cancers (leukemia) which have combined features of myeloid and lymphoid cancers. It is a rare disease, constituting about 2–5% of all leukemia cases.[1] It mostly involve myeloid with either of T lymphocyte or B lymphocyte progenitors, but in rare cases all the three cell lineages.[2] Knowledge on the cause, clinical features and cellular mechanism is poor, making the treatment and management (prognosis) difficult.[3]
The name "mixed-phenotype acute leukemia" was adopted by the World Health Organization in 2008 to include leukemias of ambiguous lineage, acute undifferentiated leukemias and natural killer lymphoblastic leukemias.[4] According to WHO criteria, myeloid lineage is characterised by the presence of myeloperoxidase, while B and T lymphoid lineages are indicated by the expression of CD19 and cytoplasmic CD3.[5]
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