Acute leukemia of ambiguous lineage entities
Acute leukemia of ambiguous lineage . |
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MPAL with defining genetic alterations |
MPAL with BCR::ABL1 |
MPAL with t(v;11q23.3); KMT2A rearranged |
MPAL with ZNF384 rearrangement |
MPAL with BCL11B activation |
MPAL with defining immunophenotypic changes |
B/myeloid MPAL |
T/myeloid MPAL |
B/T/myeloid MPAL |
B/T MPAL |
Acute undifferentiated leukemia (AUL)∗ |
ALAL, NOS† |
Acute leukemia of ambiguous lineage . |
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MPAL with defining genetic alterations |
MPAL with BCR::ABL1 |
MPAL with t(v;11q23.3); KMT2A rearranged |
MPAL with ZNF384 rearrangement |
MPAL with BCL11B activation |
MPAL with defining immunophenotypic changes |
B/myeloid MPAL |
T/myeloid MPAL |
B/T/myeloid MPAL |
B/T MPAL |
Acute undifferentiated leukemia (AUL)∗ |
ALAL, NOS† |
NOS, not otherwise specified.
AUL is defined by a lack of lineage-specific markers (as outlined in Table 2). Based on a recent multiinstitutional study, cases with a partial or single full myeloid marker can be considered as AUL.11 Cases with immunophenotype of AUL but with cytogenetic abnormalities and molecular findings diagnostic of AML with myelodysplasia-related cytogenetic abnormalities or AML with myelodysplasia-related mutation should be diagnosed as AML.
Rare cases may fulfill neither the criteria for MPAL nor acute leukemia of a single lineage or may lack all the lineage-specific markers of Table 2. Such cases are best referred to as ALAL, NOS.