In this issue of Blood, Hrusak et al show the superiority of acute lymphoblastic leukemia (ALL) type therapy in most cases of ambiguous lineage acute lymphoblastic leukemia (ALAL) in childhood. 1 ALL cells commonly express either B-cell antigens (similar to 75% of cases) or T-cell antigens (20% of cases). In similar to 4% of cases, the leukemic cells coexpress B andmyeloid antigens, or, more rarely, T plus myeloid antigens, or, extremely rarely, are trilineage positive. In a few cases, no lymphoid lineage-specific antigens are expressed. The cells appear on fluorescence-activated cell sorter staining as a single population in 75% of cases or as bilineal.
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