Mixed-phenotype acute leukemia: suboptimal treatment when the 2008/2016 WHO classification is used.
- Author:
Alan POMERANTZ
1
;
Sergio RODRIGUEZ-RODRIGUEZ
;
Roberta DEMICHELIS-GOMEZ
;
Georgina BARRERA-LUMBRERAS
;
Olga BARRALES-BENITEZ
;
Xavier LOPEZ-KARPOVITCH
;
Alvaro AGUAYO-GONZALEZ
Author Information
- Publication Type:Original Article
- Keywords: Mixed-phenotype acute leukemia; WHO classification; EGIL classification; Suboptimal treatment
- MeSH: Classification*; Disease-Free Survival; Drug Therapy; Humans; Leukemia*; Leukemia, Myeloid, Acute; Pathology; Precursor Cell Lymphoblastic Leukemia-Lymphoma; World Health Organization
- From:Blood Research 2016;51(4):233-241
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND: Different criteria have been used to diagnose mixed-phenotype acute leukemia (MPAL), which has impacted the number of individuals diagnosed with this pathology. Better outcomes have been reported when using acute lymphoblastic leukemia (ALL)-type chemotherapy in the treatment of MPAL. METHODS: We compared the outcome of 4 groups of patients with MPAL. Group 1 included patients diagnosed using the 2008/2016 World Health Organization (WHO) classification; group 2 included patients diagnosed using the European Group for the Immunological Characterization of Leukemias (EGIL) criteria; group 3 included patients diagnosed using either the EGIL or the 2008/2016 WHO criteria; and group 4 was comprised of patients diagnosed with MPAL using the EGIL classification only. RESULTS: We found a significantly worse disease-free survival (groups 1-4) and overall survival (OS) (groups 2 and 3) when comparing MPAL patients to other acute leukemia (AL) patients. A significantly better OS was obtained in patients (groups 2-4) treated with ALL-type chemotherapy compared to acute myeloid leukemia (AML)-type regimens. CONCLUSION: In light of these results, and because a trend (P=0.06) was found with regard to a better OS in group 4 when compared to other AL patients, an argument can be made that the 2008/2016 WHO classification is underpowered to diagnose all MPAL cases, potentially resulting in the suboptimal treatment of some individuals with AL.
