Hybrid leukemia is a clinical entity that includes: biphenotypic leukemia, characterized by the presence of markers of more than two lineages of a single tumor cell, bilineage leukemia, a combination of more than two lineage markers on two distinct blast cells, and biclonal leukemia, the concomitancy of more than two types of leukemic cells, derived from different clonal expansions. We present a case of a 7–year–old female diagnosed with bilineage leukemia. We propose a treatment for biphenotypic/bilineage leukemia in the cases with good prognostic factors. We suggest that hematopoietic stem cell transplantation is often not required for cure of these patients.