Thomas B Alexander1, Etan Orgel2. 1. University of North Carolina, 170 Manning Drive, 1185A Physicians Office Building, CB # 7236, Chapel Hill, NC, 27599, USA. talex@email.unc.edu. 2. Children's Hospital Los Angeles, 4650 Sunset Blvd, MS 54, Los Angeles, CA, 90027, USA.
Abstract
PURPOSE OF REVIEW: Mixed phenotype acute leukemia (MPAL) is a rare subtype of acute leukemia with features of both acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). The review examines current definitions and controversies in classification of MPAL, new insights into genomic drivers and pathogenesis, recent evidence to support treatment recommendations, and opportunities for future research. RECENT FINDINGS: Recent collaborative efforts have made progress in understanding the genomic landscape and optimal therapy for MPAL. The preponderance of retrospective data supports beginning therapy with ALL directed regimens. Differences in prognosis for adult and children with MPAL have led to divergent approaches for therapy intensity, including use of stem cell transplantation consolidation. MPAL remains a challenging leukemia to understand, research, and treat due to low incidence, shifting and subjective approaches to classification, and innate biological heterogeneity. Ongoing research hopes to surmount these obstacles through prospective studies within large cooperative groups to provide new insight into targetable biology and further refine optimal therapy.
PURPOSE OF REVIEW: Mixed phenotype acute leukemia (MPAL) is a rare subtype of acute leukemia with features of both acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). The review examines current definitions and controversies in classification of MPAL, new insights into genomic drivers and pathogenesis, recent evidence to support treatment recommendations, and opportunities for future research. RECENT FINDINGS: Recent collaborative efforts have made progress in understanding the genomic landscape and optimal therapy for MPAL. The preponderance of retrospective data supports beginning therapy with ALL directed regimens. Differences in prognosis for adult and children with MPAL have led to divergent approaches for therapy intensity, including use of stem cell transplantation consolidation. MPAL remains a challenging leukemia to understand, research, and treat due to low incidence, shifting and subjective approaches to classification, and innate biological heterogeneity. Ongoing research hopes to surmount these obstacles through prospective studies within large cooperative groups to provide new insight into targetable biology and further refine optimal therapy.
Authors: F M Uckun; H N Sather; P S Gaynon; D C Arthur; M E Trigg; D G Tubergen; J Nachman; P G Steinherz; M G Sensel; G H Reaman Journal: Blood Date: 1997-07-01 Impact factor: 22.113
Authors: Estella Matutes; Winfried F Pickl; Mars Van't Veer; Ricardo Morilla; John Swansbury; Herbert Strobl; Andishe Attarbaschi; Georg Hopfinger; Sue Ashley; Marie Christine Bene; Anna Porwit; Alberto Orfao; Petr Lemez; Richard Schabath; Wolf-Dieter Ludwig Journal: Blood Date: 2011-01-12 Impact factor: 22.113
Authors: Ondrej Hrusak; Valerie de Haas; Jitka Stancikova; Barbora Vakrmanova; Iveta Janotova; Ester Mejstrikova; Vaclav Capek; Jan Trka; Marketa Zaliova; Ales Luks; Kirsten Bleckmann; Anja Möricke; Julie Irving; Benigna Konatkowska; Thomas B Alexander; Hiroto Inaba; Kjeld Schmiegelow; Simone Stokley; Zuzana Zemanova; Anthony V Moorman; Jorge Gabriel Rossi; Maria Sara Felice; Luciano Dalla-Pozza; Jessa Morales; Michael Dworzak; Barbara Buldini; Giuseppe Basso; Myriam Campbell; Maria Elena Cabrera; Neda Marinov; Sarah Elitzur; Shai Izraeli; Drorit Luria; Tamar Feuerstein; Alexandra Kolenova; Peter Svec; Olena Kreminska; Karen R Rabin; Sophia Polychronopoulou; Elaine da Costa; Hanne Vibeke Marquart; Antonis Kattamis; Richard Ratei; Dirk Reinhardt; John K Choi; Martin Schrappe; Jan Stary Journal: Blood Date: 2018-05-02 Impact factor: 22.113
Authors: Jeffrey E Rubnitz; Mihaela Onciu; Stanley Pounds; Sheila Shurtleff; Xueyuan Cao; Susana C Raimondi; Frederick G Behm; Dario Campana; Bassem I Razzouk; Raul C Ribeiro; James R Downing; Ching-Hon Pui Journal: Blood Date: 2009-01-08 Impact factor: 22.113
Authors: Olga K Weinberg; Anna Porwit; Attilio Orazi; Robert P Hasserjian; Kathryn Foucar; Eric J Duncavage; Daniel A Arber Journal: Virchows Arch Date: 2022-10-20 Impact factor: 4.535