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Mixed phenotype acute leukemia (MPAL): clinical and laboratory features and outcome in 100 patients defined according to the WHO 2008 classification.
MedLine Citation:
PMID:  21228332     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
The features of 100 mixed phenotype acute leukemias (MPAL), fulfilling the WHO 2008 criteria are documented. Myeloid and T-lineage features were demonstrated by cytoplasmic myeloperoxidase and CD3, B-lineage by at least two B-lymphoid markers. There were 62 males and 38 females; 68% were adults. Morphology was consistent with ALL (43%), AML (42%) or inconclusive (15%). Immunophenotyping disclosed B+Myeloid (59%), T+Myeloid (35%), B+T (4%) or trilineage (2%) combinations. Cytogenetics evidenced t(9;22)/(Ph+) (20%), 11q23/MLL-rearrangements (8%), complex (32%), aberrant (27%) or normal (13%) karyotypes. There was no significant correlation between age, morphology, immunophenotype or cytogenetics. Response to treatment and outcome were available for 67 and 70 patients respectively; 27 received ALL, 34 AML, five a combination of ALL+AML therapy and one received imatinib. ALL treatment induced a response in 85% of patients, AML therapy in 41% and 3/5 patients responded to the combination therapy. Forty (58%) patients died, 33 of resistant/relapsed disease. Overall median survival was 18 months and 37% of the patients are alive at 5 years. Age, Ph+ and AML therapy were predictors for poor outcome (p<0.001; p=0.002; p=0.003). MPAL is confirmed to be a poor risk disease. Adults and Ph+ patients should be considered for stem-cell transplant in first remission.
Authors:
Estella Matutes; Winfried F Pickl; Mars Van't Veer; Ricardo Morilla; John Swansbury; Herbert Strobl; Andishe Attarbaschi; Georg Hopfinger; Sue Ashley; Marie C Bene; Anna Porwit; Alberto Orfao; Petr Lemez; Richard Schabath; Wolf-Dieter Ludwig
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-1-12
Journal Detail:
Title:  Blood     Volume:  -     ISSN:  1528-0020     ISO Abbreviation:  -     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-1-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7603509     Medline TA:  Blood     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Haemato-Oncology, Royal Marsden Hospital, Institute of Cancer Research, London, United Kingdom;
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