Allogeneic Hematopoietic Stem Cell Transplantation with Myeloablative Conditioning Is Associated with Favorable Outcomes in Mixed Phenotype Acute Leukemia

Bartlomiej M. Getta, Mikhail Roshal, Junting Zheng, Jae H. Park, Eytan M. Stein, Ross Levine, Esperanza B. Papadopoulos, Ann A. Jakubowski, Nancy A. Kernan, Peter Steinherz, Richard J. O'Reilly, Miguel Angel Perales, Sergio A. Giralt, Martin S. Tallman, Brian C. Shaffer*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

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 languageEnglish (US)
Pages (from-to)1879-1886
Number of pages8
JournalBiology of Blood and Marrow Transplantation
Volume23
Issue number11
DOIs
StatePublished - Nov 2017

Keywords

  • Allogeneic hematopoietic cell transplantation
  • Mixed phenotype acute leukemia
  • Somatic mutations

ASJC Scopus subject areas

  • Transplantation
  • Hematology

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