Biphenotypic acute leukaemia (BAL) is an uncommon type of leukemia which arises in multipotent progenitor cells which have the ability to differentiate into both myeloid and lymphoid lineages.

it is very common in BAL patients, most of patients die due to the A low level of red blood cells in the bloodstream: Because the decline of hematopoietic function, need blood transfusion therapy Persistent fever, infection prolonged healing: Diffuse hemorrhage: which is dangerous and might lead to death.

Symptoms caused by blood cancer cells infiltration into tissues: Swollen lymph nodes Joint pain Swelling of the gums Enlargement of the liver and spleen Headache and vomiting: blood cancer infiltration into the wear performance of the central nervous system.

ABL/BCR could active several molecular pathways: MLL gene encode Histone-lysine N-methyltransferase (HRX), which is a histone methyltransferase.

The presence of specific T-lymphoid antigens, cytoplasmic CD3 (cCD3), MPO and CD 19 became the most important standard for recognizing the lineage.

BAL is difficult to treat, most patients receive treatment based on the morphology of blasts and get AML or ALL induction chemotherapy.

[11] Chemotherapy has strong side effects such as typhlitis, gastrointestinal distress, anemia, fatigue, hair loss, nausea and vomiting, etc.

In another study, the results showed that young age, normal karyotype and ALL induction therapy will have a better prognosis than Ph+, adult patients.

[13][14] Research on the mechanisms of BAL does not show a great progress in terms of the causes, molecular processes and therapy.

[16] For t(15;17), the blasts with morphology of acute lymphoblastic leukemia co-expressed in B-lymphoid and myeloid lineages, and the cytogenetic study showed that the 4q21 abnormalities and t(15;17).

However, promyelocytic-retinoid acid receptor rearrangement was not found by fluorescence in situ hybridization on interphase nuclei.

For example, The chemotherapy for ALL and gemtuzuab ozogamicin without all-trans-retinoic acid remain complete remission of the BAL patients with t(15,17) for more than 3.7 years.

[17] The detection of BCR-ABL1 chimeric gene neutrophils was also found a good method for diagnosis some cases of BAL.