ArticleCancer2020
Mixed-phenotype acute leukemia: A cohort and consensus research strategy from the Children's Oncology Group Acute Leukemia of Ambiguous Lineage Task Force.
Article in Cancer, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
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Who cites it
25 citing papers in PubMed, 68 citations in OpenAlex.
- Improved survival with fludarabine-based therapies in mixed phenotype acute leukaemia: A population-based study using the WHO 2022 classification.British journal of haematology · 2026Article
- The Efficiency of Allotransplant in a Case of Acute Biphenotypic Myeloid and B-Lymphoid Leukemia (MPAL Myelo/B NOS) That Presented Concurrently with a Mediastinal Granulocytic Sarcoma Co-Expressing Lymphoid Markers Complicated by Cardiac Tamponade.Diagnostics (Basel, Switzerland) · 2026Article
- Acute leukemia of ambiguous lineage: the known and the uncertain.Haematologica · 2026Review
- Immunophenotypically Defined Mixed-Phenotype Acute Leukemias: A Clinicopathologic Analysis of 52 Cases.EJHaem · 2026Article
- Efficacy and safety of mini-cvd combined with venetoclax and azacitidine in philadelphia chromosome-negative acute leukemia of ambiguous lineage: a single-center retrospective study.Annals of hematology · 2026Article
- Single-cell transcriptome analysis defines novel molecular subtypes and reveals therapeutic implications of T/myeloid mixed-phenotype acute leukemia.Genome medicine · 2025Article
- B/T Mixed Phenotype Acute Leukaemia HarbouringEJHaem · 2025Article
- Novel classification system and high-risk categories of pediatric acute myeloid leukemia.Haematologica · 2025Review
- Transcriptional profiling directs the classification of acute leukemias of ambiguous lineage into AML, B-ALL, or T-ALL.HemaSphere · 2025Article
- Article
- Defining 2 biologically and clinically distinct groups in acute leukemia with a mixed phenotype.Blood · 2025Article
- Mixed phenotype acute leukemia, the dissection of an enigmatic disease in the era of novel therapies.Frontiers in pediatrics · 2025Review
- Clinical features of immature leukemias in children.International journal of hematology · 2024Article
- Review
- Genomic heterogeneity within B/T mixed phenotype acute leukemia in a context of an immunophenotype.Leukemia research reports · 2024Article
- Molecular characterization and clinical outcome of B-cell precursor acute lymphoblastic leukemia with IG-MYC rearrangement.Haematologica · 2023Article
- Review
- Rare Case of Mixed Phenotype Acute Leukemia Presenting as a Myeloid Sarcoma Without Leukemic Involvement.The Permanente journal · 2022Article
- Characteristics, Treatment Complexity, and Outcome of Mixed-Phenotype Acute Leukemia in Children in a Low-Middle-Income Country.Frontiers in oncology · 2022Article
- Pediatric Mixed-Phenotype Acute Leukemia: What's New?Cancers · 2021Review
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Authors and funding
21 authors at 16 institutions in 2 countries.
Funding
Abstract
backgroundOptimal chemotherapy for treating mixed-phenotype acute leukemia (MPAL) and the role of hematopoietic stem cell transplantation (HSCT) remain uncertain. Major limitations in interpreting available data are MPAL's rarity and the use of definitions other than the currently widely accepted criteria: the World Health Organization 2016 (WHO2016) classification.
methodsTo assess the relative efficacy of chemotherapy types for treating pediatric MPAL, the Children's Oncology Group (COG) Acute Leukemia of Ambiguous Lineage Task Force assembled a retrospective cohort of centrally reviewed WHO2016 MPAL cases selected from banking studies for acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). Patients were not treated in COG trials; treatment and outcome data were captured separately. The findings were then integrated with the available, mixed literature to develop a prospective trial in pediatric MPAL.
resultsThe central review confirmed that 54 of 70 cases fulfilled WHO2016 criteria for MPAL. ALL induction regimens achieved remission in 72% of the cases (28 of 39), whereas AML regimens achieved remission in 69% (9 of 13). The 5-year event-free survival (EFS) and overall survival (OS) rates for the entire cohort were 72% ± 8% and 77% ± 7%, respectively. EFS and OS were 75% ± 13% and 84% ± 11%, respectively, for those receiving ALL chemotherapy alone without HSCT (n = 21).
conclusionsThe results of the COG MPAL cohort and a literature review suggest that ALL chemotherapy without HSCT may be the preferred initial therapy. A prospective trial within the COG is proposed to investigate this approach; AML chemotherapy and/or HSCT will be reserved for those with treatment failure as assessed by minimal residual disease. Embedded biology studies will provide further insight into MPAL genomics.
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