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Mixed phenotype acute leukemia: Biological profile, clinical characteristic and treatment outcomes: Report of the population‐based study
Author(s) -
ZającSpychała Olga,
IrgaJaworska Ninela,
Drożyńska Elżbieta,
MuszyńskaRosłan Katarzyna,
KrawczukRybak Maryna,
Zawitkowska Joanna,
Kowalczyk Jerzy,
Ćwiklińska Magdalena,
Balwierz Walentyna,
MiziaMalarz Agnieszka,
Badowska Wanda,
Kamieńska Elżbieta,
Urasiński Tomasz,
Kaczorowska Aneta,
Kazanowska Bernarda,
Chybicka Alicja,
Wysocki Mariusz,
Sędek Łukasz,
Szczepański Tomasz,
Woszczyk Mariola,
Matysiak Michał,
Młynarski Wojciech,
Karolczyk Grażyna,
Chaber Radosław,
Wachowiak Jacek
Publication year - 2020
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.13413
Subject(s) - medicine , chemotherapy , myeloid leukemia , population , induction chemotherapy , retrospective cohort study , myeloid , oncology , pediatrics , gastroenterology , environmental health
Objectives The aim of this population‐based, retrospective study was to analyze biological and clinical features and treatment results in children diagnosed with MPAL in all Polish pediatric oncology centers between 2007 and 2018. Methods Among 2893 children and adolescents diagnosed and treated for acute leukemia, 39 (1.35%) patients fulfilled the WHO criteria of MPAL. The T/myeloid phenotype was most prevalent. Results Cytogenetics findings were seen in 2 (5.1%), while chromosomal abnormalities were found in 14 (35.9%) patients. Thirty‐two patients achieved CR‐1, including 23 (92.0%) treated with ALL‐directed chemotherapy and 9 (64.3%) treated with AML‐type induction regimens. Within these patients, 4 (12.5%) died due to treatment‐related complications and 11 (34.4%) relapsed. Nineteen (63.3%) patients underwent allo‐HSCT in CR‐1 and 14 (73.7%) of them have been in CR‐1. In total, 17 (43.6%) patients remain in CR‐1 for 1‐12 years, including 14 (58.3%) with T/myeloid MPAL. The 5‐year pOS and pEFS were 51.8% and 44.2%, respectively. The overall survival for ALL‐directed therapy was significantly better than the one for AML‐type chemotherapy ( P = .001). It was also better for patients who underwent HSCT in CR‐1 ( P = .001). Conclusions The prognosis of MPAL is unsatisfactory, but initial treatment with ALL‐directed chemotherapy consolidated with allo‐HSCT improves the outcomes in MPAL.