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Acute lymphoblastic leukemia-like treatment regimen provides better response in mixed phenotype acute leukemia: a

Eman O Rasekh1, Randa Osman1, Dalia Ibraheem2

  • 1Clinical Pathology Department, National Cancer Institute, Cairo University, Foum elkhalig Sq., Cairo, Egypt.

Annals of Hematology
|November 24, 2020
PubMed

Insights

Mixed phenotype acute leukemia (MPAL) is rare. Patients responded better to acute lymphoblastic leukemia (ALL)-like treatment, particularly adults, suggesting a lymphoid-driven approach for MPAL.

Area of Science:

  • Hematology
  • Oncology
  • Leukemia Research

Background:

  • Mixed phenotype acute leukemia (MPAL) is a rare hematologic malignancy characterized by myeloid and lymphoid lineage markers.
  • Limited research exists on MPAL's clinical spectrum and optimal treatment strategies.
  • MPAL diagnosis requires adherence to specific World Health Organization (WHO) criteria.

Purpose of the Study:

  • To characterize the clinical features of MPAL.
  • To compare outcomes between adult and pediatric MPAL patient groups.
  • To evaluate the efficacy of different treatment regimens in MPAL.

Main Methods:

  • Retrospective analysis of 102 MPAL cases diagnosed between 2008-2016.
  • Comparison of clinical characteristics and treatment responses across age groups.
  • Evaluation of treatment regimens, including ALL-like and myeloid-based therapies.

Main Results:

  • MPAL accounted for 4% of acute leukemia cases (102/2571).
  • The myeloid/B-lymphoid phenotype was most common (84%), with BCR-ABL detected in 13.7%.
  • ALL-like treatment yielded significantly better response rates than myeloid-based regimens (p=0.001).

Conclusions:

  • MPAL exhibits clinical features similar to lymphoid leukemias in both adults and pediatric patients.
  • An ALL-like treatment approach appears superior for MPAL, especially in adult populations.
  • Further research is warranted to refine MPAL treatment protocols.
Keywords:
Acute lymphoblastic leukemia–like treatmentMixed phenotype acute leukemiaPhiladelphia positive MPAL

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