title: Features and clinical outcomes in 40 patients with mixed-lineage acute leukemia in a single center.
abstract: Mixed-lineage acute leukemia (MAL) is characterized as acute leukemia involving acute myeloid cells and lymphoid cells at the same time. It is easily misdiagnosed because of the dual characteristics involving both lymphoid and myeloid cells and has a poor prognosis. We retrospectively analyzed the features and treatment effectiveness in a single center in 40 patients with MAL. The morphology was consistent with acute lymphoblastic leukemia (ALL) (47.5%) or acute myeloid leukemia (AML) (20%) or was inconclusive (32.5%). Twenty-two patients were characterized as B/myeloid, and 18 patients as T/myeloid. Cytogenetics showed t(9;22)/(Ph(+)) (12.5%) and 11q23/MLL rearrangements (6.25%). The rate of first complete remission for patients undergoing chemotherapy based on the features of both ALL and AML and of either ALL or AML was 71.4 and 42.9%, respectively. The 1-year overall survival rates were 37.5 and 60.0% for chemotherapy and chemotherapy followed by haploidentical hematopoietic stem cell transplantation (HSCT), respectively. The 1-year disease-free survival rates were 25.0 and 50.0% for chemotherapy and chemotherapy followed by HSCT, respectively. These results showed that MAL is confirmed to be a poor-risk disease. The chemotherapy for remission induction should be based on both myeloid cells and lymphoid cells. Transplantation should be performed after the first remission.
authors.affiliation: The Third Military Medical University, Chongqing, People's Republic of China.
authors.forename: Cheng
authors.initials: C
authors.lastname: Zhang
authors.forename: Xi
authors.initials: X
authors.lastname: Zhang
authors.forename: Xing-Hua
authors.initials: XH
authors.lastname: Chen
authors.forename: Lei
authors.initials: L
authors.lastname: Gao
authors.forename: Li
authors.initials: L
authors.lastname: Gao
authors.forename: Yao
authors.initials: Y
authors.lastname: Liu
authors.forename: Pei-Yan
authors.initials: PY
authors.lastname: Kong
authors.forename: Dong-Feng
authors.initials: DF
authors.lastname: Zeng
authors.forename: Xian-Gui
authors.initials: XG
authors.lastname: Peng
authors.forename: Ai-Hua
authors.initials: AH
authors.lastname: Sun
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002648:Child; D005260:Female; D005434:Flow Cytometry; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D016130:Immunophenotyping; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D011379:Prognosis; D019172:Transplantation Conditioning; D016896:Treatment Outcome; D055815:Young Adult