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Mixed phenotype acute leukemia

MedGen UID:
417342
Concept ID:
C2826025
Neoplastic Process
Synonyms: Mixed lineage acute leukemia; Mixed lineage leukemia
SNOMED CT: Acute mixed lineage leukemia (450913003); Mixed phenotype acute leukemia (450913003); Mixed phenotype acute leukemia (1187123005); MPAL - mixed phenotype acute leukemia (1187123005)
 
Monarch Initiative: MONDO:0020743
Orphanet: ORPHA530995

Definition

A group of rare acute leukemias of ambiguous lineage characterized by the presence of separate populations of blasts of more than one lineage (bilineal), a single population of blasts coexpressing antigens of more than one lineage (biphenotypic), or a combination thereof. The diagnosis relies on immunophenotyping, the T-cell component being characterized by strong expression of cytoplasmic CD3, usually in the absence of surface CD3, the B-cell component expressing CD19, almost always together with CD10, cCD79a, CD22, or PAX5, while the most specific hallmark of the myeloid component is the presence of myeloperoxidase in the blast cytoplasm. [from ORDO]

Professional guidelines

PubMed

Alexander TB, Orgel E
Curr Oncol Rep 2021 Feb 5;23(2):22. doi: 10.1007/s11912-020-01010-w. PMID: 33544265
Dworzak MN, Buldini B, Gaipa G, Ratei R, Hrusak O, Luria D, Rosenthal E, Bourquin JP, Sartor M, Schumich A, Karawajew L, Mejstrikova E, Maglia O, Mann G, Ludwig WD, Biondi A, Schrappe M, Basso G; International-BFM-FLOW-network
Cytometry B Clin Cytom 2018 Jan;94(1):82-93. Epub 2017 Feb 21 doi: 10.1002/cyto.b.21518. PMID: 28187514
Charles NJ, Boyer DF
Arch Pathol Lab Med 2017 Nov;141(11):1462-1468. doi: 10.5858/arpa.2017-0218-RA. PMID: 29072953

Recent clinical studies

Etiology

Di Giacomo D, La Starza R, Gorello P, Pellanera F, Kalender Atak Z, De Keersmaecker K, Pierini V, Harrison CJ, Arniani S, Moretti M, Testoni N, De Santis G, Roti G, Matteucci C, Bassan R, Vandenberghe P, Aerts S, Cools J, Bornhauser B, Bourquin JP, Piazza R, Mecucci C
Blood 2021 Sep 2;138(9):773-784. doi: 10.1182/blood.2020010510. PMID: 33876209Free PMC Article
Alexander TB, Orgel E
Curr Oncol Rep 2021 Feb 5;23(2):22. doi: 10.1007/s11912-020-01010-w. PMID: 33544265
Cernan M, Szotkowski T, Pikalova Z
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2017 Sep;161(3):234-241. Epub 2017 Apr 18 doi: 10.5507/bp.2017.013. PMID: 28422191
Wolach O, Stone RM
Curr Opin Hematol 2017 Mar;24(2):139-145. doi: 10.1097/MOH.0000000000000322. PMID: 28099272
Ye Z, Wang S
Chin Med J (Engl) 2014;127(16):2999-3003. PMID: 25131241

Diagnosis

Hennawi M, Pakasticali N, Tashkandi H, Hussaini M
Int J Mol Sci 2022 Sep 24;23(19) doi: 10.3390/ijms231911259. PMID: 36232559Free PMC Article
Weinberg OK, Arber DA
Am J Clin Pathol 2022 Jul 1;158(1):27-34. doi: 10.1093/ajcp/aqac070. PMID: 35775438
Alexander TB, Orgel E
Curr Oncol Rep 2021 Feb 5;23(2):22. doi: 10.1007/s11912-020-01010-w. PMID: 33544265
Chen X, Cherian S
Clin Lab Med 2017 Dec;37(4):753-769. Epub 2017 Aug 31 doi: 10.1016/j.cll.2017.07.003. PMID: 29128067
Charles NJ, Boyer DF
Arch Pathol Lab Med 2017 Nov;141(11):1462-1468. doi: 10.5858/arpa.2017-0218-RA. PMID: 29072953

Therapy

Zou JY, Huang SM, Zhoub HX, Xu MZ, Sun AN, Wu DP, Xue SL, Zhang TT
Hematology 2023 Dec;28(1):2237790. doi: 10.1080/16078454.2023.2237790. PMID: 37477259
Di Giacomo D, La Starza R, Gorello P, Pellanera F, Kalender Atak Z, De Keersmaecker K, Pierini V, Harrison CJ, Arniani S, Moretti M, Testoni N, De Santis G, Roti G, Matteucci C, Bassan R, Vandenberghe P, Aerts S, Cools J, Bornhauser B, Bourquin JP, Piazza R, Mecucci C
Blood 2021 Sep 2;138(9):773-784. doi: 10.1182/blood.2020010510. PMID: 33876209Free PMC Article
Andrews C, Tierens A, Minden M
Crit Rev Clin Lab Sci 2021 May;58(3):153-166. Epub 2020 Nov 8 doi: 10.1080/10408363.2020.1829537. PMID: 33161794
Khan M, Siddiqi R, Naqvi K
Ann Hematol 2018 Jun;97(6):945-953. Epub 2018 Mar 15 doi: 10.1007/s00277-018-3297-6. PMID: 29546454
Béné MC, Porwit A
Semin Diagn Pathol 2012 Feb;29(1):12-8. doi: 10.1053/j.semdp.2011.08.004. PMID: 22372202

Prognosis

Hennawi M, Pakasticali N, Tashkandi H, Hussaini M
Int J Mol Sci 2022 Sep 24;23(19) doi: 10.3390/ijms231911259. PMID: 36232559Free PMC Article
Alexander TB, Orgel E
Curr Oncol Rep 2021 Feb 5;23(2):22. doi: 10.1007/s11912-020-01010-w. PMID: 33544265
Charles NJ, Boyer DF
Arch Pathol Lab Med 2017 Nov;141(11):1462-1468. doi: 10.5858/arpa.2017-0218-RA. PMID: 29072953
Cernan M, Szotkowski T, Pikalova Z
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2017 Sep;161(3):234-241. Epub 2017 Apr 18 doi: 10.5507/bp.2017.013. PMID: 28422191
Ye Z, Wang S
Chin Med J (Engl) 2014;127(16):2999-3003. PMID: 25131241

Clinical prediction guides

Nishimura A, Yokoyama K, Naruto T, Yamagishi C, Imamura T, Nakazono H, Kimura S, Ito M, Sagisaka M, Tanaka Y, Piao J, Namikawa Y, Yanagimachi M, Isoda T, Kanai A, Matsui H, Isobe T, Sato-Otsubo A, Higuchi N, Takada A, Okuno H, Saito S, Karakawa S, Kobayashi S, Hasegawa D, Fujisaki H, Hasegawa D, Koike K, Koike T, Rai S, Umeda K, Sano H, Sekinaka Y, Ogawa A, Kinoshita A, Shiba N, Miki M, Kimura F, Nakayama H, Nakazawa Y, Taga T, Taki T, Adachi S, Manabe A, Koh K, Ishida Y, Takita J, Ishikawa F, Goto H, Morio T, Mizutani S, Tojo A, Takagi M
Sci Adv 2023 Dec 15;9(50):eadj4407. Epub 2023 Dec 13 doi: 10.1126/sciadv.adj4407. PMID: 38091391Free PMC Article
Mumme HL, Raikar SS, Bhasin SS, Thomas BE, Lawrence T, Weinzierl EP, Pang Y, DeRyckere D, Gawad C, Wechsler DS, Porter CC, Castellino SM, Graham DK, Bhasin M
Genome Med 2023 Oct 16;15(1):83. doi: 10.1186/s13073-023-01241-z. PMID: 37845689Free PMC Article
Wolach O, Stone RM
Curr Opin Hematol 2020 Mar;27(2):95-102. doi: 10.1097/MOH.0000000000000570. PMID: 31913151
Granja JM, Klemm S, McGinnis LM, Kathiria AS, Mezger A, Corces MR, Parks B, Gars E, Liedtke M, Zheng GXY, Chang HY, Majeti R, Greenleaf WJ
Nat Biotechnol 2019 Dec;37(12):1458-1465. Epub 2019 Dec 2 doi: 10.1038/s41587-019-0332-7. PMID: 31792411Free PMC Article
Kang ZJ, Liu YF, Xu LZ, Long ZJ, Huang D, Yang Y, Liu B, Feng JX, Pan YJ, Yan JS, Liu Q
Chin J Cancer 2016 May 27;35:48. doi: 10.1186/s40880-016-0108-0. PMID: 27233483Free PMC Article

Recent systematic reviews

Durer S, Durer C, Shafqat M, Comba IY, Malik S, Faridi W, Aslam S, Ijaz A, Tariq MJ, Fraz MA, Usman M, Khan AY, McBride A, Anwer F
Immunotherapy 2019 Apr;11(5):373-378. doi: 10.2217/imt-2018-0104. PMID: 30786841Free PMC Article
Maruffi M, Sposto R, Oberley MJ, Kysh L, Orgel E
Leukemia 2018 Jul;32(7):1515-1528. Epub 2018 Feb 27 doi: 10.1038/s41375-018-0058-4. PMID: 29550836Free PMC Article

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