title: [Study on the clinical characteristics of 32 patients with mixed phenotype acute leukemia].
abstract: OBJECTIVE
  To investigate the clinical and biological characteristics and prognosis of mixed phenotype acute leukemia (MPAL).
  
  
  METHODS
  Thirty two patients were diagnosed as MPAL by bone marrow examination, immunophenotyping, cytogenetic and molecular assay and were treated with combined chemotherapy regimens for both acute lymphoblastic and acute myeloid leukemia. Two cases were received allogeneic hematopoietic stem cell transplantation (allo-HSCT).
  
  
  RESULTS
  (1) The incidence of MPAL in acute leukemias was 2.6%. There were 16 cases (50.0%) of mixed myeloid and B-lymphoid (M/B), 14(43.8%) myeloid and T-lymphoid (M/T), one each (3.1%) of trilineage (M/B/T) and B- and T-lymphoid (B/T) phenotype. (2) The positive rates of CD34 and HLA-DR were 87.5% and 62.5%, respectively. (3) Abnormal karyotypes were detected in 70.0% of 30 MPAL patients, which were structural and numerical abnormalities including t(9;22), 11q23 and complex karyotypes. (4) The total complete remission (CR) rate was 75.0% and the overall survival (OS) and disease-free survival (DFS) at 2 years were 14.8% and 14.2% respectively. The CR rates for M/B and M/T cases were 75.0% and 71.4% respectively. No statistical difference was observed in OS and DFS between M/B and M/T cases.
  
  
  CONCLUSIONS
  MPAL is a rare type of acute leukemia with a high heterogeneity. The unfavorable indicators of MPAL may be factors such as abnormal karyotypes, high expression of CD34 and extramedullary infiltration. Combined regimens and more intensive therapy including allo-HSCT might contribute to improving survival.
authors.affiliation: Department of Hematology, First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Suzhou 215006, China.
authors.forename: Yan-ming
authors.initials: YM
authors.lastname: Zhang
authors.forename: De-pei
authors.initials: DP
authors.lastname: Wu
authors.forename: Ai-ning
authors.initials: AN
authors.lastname: Sun
authors.forename: Hui-ying
authors.initials: HY
authors.lastname: Qiu
authors.forename: Yu-mei
authors.initials: YM
authors.lastname: Sun
authors.forename: Guang-sheng
authors.initials: GS
authors.lastname: He
authors.forename: Zheng-ming
authors.initials: ZM
authors.lastname: Jin
authors.forename: Xiao-wen
authors.initials: XW
authors.lastname: Tang
authors.forename: Miao
authors.initials: M
authors.lastname: Miao
authors.forename: Zheng-zheng
authors.initials: ZZ
authors.lastname: Fu
authors.forename: Yue
authors.initials: Y
authors.lastname: Han
authors.forename: Su-ning
authors.initials: SN
authors.lastname: Chen
authors.forename: Ming-qing
authors.initials: MQ
authors.lastname: Zhu
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D016130:Immunophenotyping; D059785:Karyotype; D015456:Leukemia, Biphenotypic, Acute / Q000145:classification / Q000235:genetics* / Q000276:immunology*; D015470:Leukemia, Myeloid, Acute / Q000235:genetics / Q000276:immunology; D008297:Male; D008875:Middle Aged; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000235:genetics / Q000276:immunology; D011379:Prognosis; D055815:Young Adult