Acute Leukemia of Ambiguous Lineage refers to an acute leukemia without clear evidence of differentiation along a single lineage according to the 2008 WHO classification.


Definition: no clear evidence of differentiation following extensive evaluation using multi-parametric flow cytometry immunophenotyping




acute undifferentiated leukemia (AUL)

no markers for a lineage identified, may show CD34 and/or HLA-DR

mixed-phenotypic (MPAL, biphenotypic, triphenotypic)

B/myeloid, T/myeloid, B/T, B/T/myeloid


early NK leukemia, other


Mixed phenotype acute leukemia (MPAL) are subdivided into cytogentic anomalies:

(1) t(9;22)/BCR-ABL1

(2) t(n;11q23)/MLL

(3) other


Differential diagnosis:

(1) acute unclassifiable leukemia due to insufficient data


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