Abstract
Mixed phenotype acute leukemia (MPAL) represents a poorly characterized group of acute leukemias that lack an accepted therapeutic approach and are typically associated with poor outcomes. We present our experience of genomic profiling, pretransplantation therapy, and transplantation outcomes for 36 well-characterized pediatric and adult patients with MPAL, defined according to the 2016 World Health Organization leukemia update. A predominance of acute lymphoid leukemia (ALL)–associated mutations and cytogenetic abnormalities was noted. Remission rates after induction appeared comparable among adults (20 of 23) and children (11 of 13) and among those who received ALL (10 of 11) or acute myeloid leukemia–type (21 of 25) induction. Adults underwent transplantation in first remission while children underwent transplantation in the setting of relapse or MLL rearrangement. The median follow-up among the 25 patients who underwent transplantation was 39.6 months and median overall survival was not reached. Relapse after transplantation was associated with MLL rearrangement (P =.022), reduced-intensity conditioning (P <.001), and higher WBC at diagnosis (P =.034). These data highlight differing therapeutic approaches between adult and pediatric MPAL and demonstrate favorable survival of adult MPAL patients consolidated with allogeneic hematopoietic cell transplantation.
Original language | English (US) |
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Pages (from-to) | 1879-1886 |
Number of pages | 8 |
Journal | Biology of Blood and Marrow Transplantation |
Volume | 23 |
Issue number | 11 |
DOIs | |
State | Published - Nov 2017 |
Funding
This research was supported in part by National Institutes of Health award number P01 CA23766 and NIH/NCI Cancer Center Support Grant P30 CA008748. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. This research was supported in part by National Institutes of Health award number P01 CA23766 and NIH/NCI Cancer Center Support Grant P30 CA008748 . The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Financial disclosure: The authors have nothing to disclose. Conflict of interest statement: There are no conflicts of interest to report. Authorship statement: B.M.G., M.R., and B.S. collected and analyzed data and wrote manuscript. J.Z. analyzed data and wrote manuscript. M.T., J.H.P., E.M.S., R.L., E.B.P., N.K., P.S., R.J.O., M.A.P., and S.G. wrote the manuscript. Appendix
Keywords
- Allogeneic hematopoietic cell transplantation
- Mixed phenotype acute leukemia
- Somatic mutations
ASJC Scopus subject areas
- Transplantation
- Hematology