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Mixed Phenotype Acute Leukemia with 3 lineages differentiation & the challenge in the establishing of the diagnosis: a case report

Hematology & Transfusion International Journal
Mariam Al Ghazal,1 Mona Al Zaher,2 Rehab Bu Khamseen1  

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Mixed phenotype acute leukemia (MPAL) is a rare form of acute leukemia comprising 2% to 3% of all acute leukemia diagnoses. The diagnosis of MPAL is based on flow cytometric analysis of the immunophenotype, which demonstrates expression of differentiation-related antigens belonging to multiple lineages commonly, one lineage is myeloid and the other is B and/or T lymphoid. Whether lineage differentiation determines clinical presentation and outcomes is unclear.

Here we report a case of 37 years old man who presented with leukocytosis & found to have MPAL (mixed phenotype acute leukemia) with possible differentiation to 3 lineages as evident by flowcytometry cases with trilineage antigenic determinants are very rare.


phenotype, acute leukemia, trilineage, . Bone Marrow, antigens