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Philadelphia chromosome‐positive mixed phenotype acute leukemia in the imatinib era
Author(s) -
Shimizu Hiroaki,
Yokohama Akihiko,
Hatsumi Nahoko,
Takada Satoru,
Handa Hiroshi,
Sakura Toru,
Nojima Yoshihisa
Publication year - 2014
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/ejh.12343
Subject(s) - imatinib , medicine , myeloid leukemia , context (archaeology) , philadelphia chromosome , chemotherapy , leukemia , acute leukemia , myeloid , gastroenterology , oncology , immunology , biology , chromosomal translocation , gene , paleontology , biochemistry
Although the introduction of imatinib dramatically improved the outcomes for patients with P hiladelphia chromosome‐positive B ‐cell precursor acute lymphoblastic leukemia ( P h+ BCP ‐ ALL ), the survival benefit of imatinib has not been assessed in the context of P h+ mixed phenotype acute leukemia ( P h+ MPAL ). To clarify this important issue, we studied 42 P h+ acute leukemia ( P h+ AL ) patients who received intensive chemotherapy and concurrent administration of imatinib. Of the 42 P h+ AL patients, 13 (31%) patients were categorized as P h+ MPAL (positive for both myeloid and B ‐cell lineage), 27 (64%) were categorized as P h+ BCP ‐ ALL , and two (5%) were categorized as P h+ acute myeloid leukemia. The complete remission rates after the initial induction therapy were not significantly different when comparing P h+ MPAL and P h+ BCP ‐ ALL patients (100% vs. 85%, respectively, P = 0.14). Likewise, there were no significant differences in the 5‐yr overall survival ( OS ) or disease‐free survival ( DFS ) rates when comparing the MPAL and BCP ‐ ALL groups ( OS : 55% vs. 53%, respectively, P = 0.87, DFS : 46% vs. 42%, respectively, P = 0.94). These findings suggest that concurrent imatinib administration with chemotherapy improved the outcomes of P h+ MPAL patients to the level seen in P h+ BCP ‐ ALL patients and should, therefore, be considered as the standard therapy for these patients.