title: Children Diagnosed as Mixed-Phenotype Acute Leukemia Didn't Benefit from the CCLG-2008 Protocol, Retrospective Analysis from Single Center.
abstract: Mixed phenotype acute leukemia (MPAL) is a rare type of acute leukemia with a poor clinical outcome which lacks specific therapy. To evaluate the therapeutic efficiency of CCLG-2008 protocol used for acute lymphoblastic leukemia (ALL) in China on MPAL children who were initially diagnosed as ALL by morphology, we reviewed patients' database diagnosed as ALL and MPAL according to WHO classification and compared their outcomes from July 2008 to June 2012. Total newly enrolled ALL in this study were 309 cases by morphology, in which ten cases were identified as MPAL mainly by immunophenotyping: B+ myeloid (3/10), T+ myeloid (2/10), B + T (4/10), trilineage (1/10). Two cases were classified as intermediate risk (IR) and 8 cases were high risk (HR) according to the CCLG-2008 criteria. Only one case of IR survived and others died due to primary resistance of chemotherapy and relapse. Compared with MPAL, ALL children in IR and HR had a longer survival (28.1 vs 9.5 months, p < 0.0001) and lower relapse (16.3 vs 85.7 %, p = 0.0002). In a summary, our result indicated that MPAL in children is a poor-risk disease which needs personalized therapy to improve outcome.
authors.affiliation: Department of Hematology and Oncology, Children's Hospital of Soochow University, Suzhou, 215003 China.
authors.forename: Jing
authors.initials: J
authors.lastname: Lu
authors.affiliation: Department of Hematology and Oncology, Children's Hospital of Soochow University, Suzhou, 215003 China.
authors.forename: Neetika
authors.initials: N
authors.lastname: Ashwani
authors.affiliation: Department of Hematology and Oncology, Children's Hospital of Soochow University, Suzhou, 215003 China.
authors.forename: Mingying
authors.initials: M
authors.lastname: Zhang
authors.affiliation: Department of Hematology and Oncology, Children's Hospital of Soochow University, Suzhou, 215003 China.
authors.forename: Hailong
authors.initials: H
authors.lastname: He
authors.affiliation: Department of Hematology and Oncology, Children's Hospital of Soochow University, Suzhou, 215003 China.
authors.forename: Jun
authors.initials: J
authors.lastname: Lu
authors.affiliation: Department of Hematology and Oncology, Children's Hospital of Soochow University, Suzhou, 215003 China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Hematology and Oncology, Children's Hospital of Soochow University, Suzhou, 215003 China.
authors.forename: Wenli
authors.initials: W
authors.lastname: Zhao
authors.affiliation: Department of Hematology and Oncology, Children's Hospital of Soochow University, Suzhou, 215003 China.
authors.forename: Lan
authors.initials: L
authors.lastname: Cao
authors.affiliation: Department of Hematology and Oncology, Children's Hospital of Soochow University, Suzhou, 215003 China.
authors.forename: Zhenghua
authors.initials: Z
authors.lastname: Ji
authors.affiliation: Department of Hematology and Oncology, Children's Hospital of Soochow University, Suzhou, 215003 China.
authors.forename: Yaxiang
authors.initials: Y
authors.lastname: He
authors.affiliation: Department of Hematology and Oncology, Children's Hospital of Soochow University, Suzhou, 215003 China.
authors.forename: Yiping
authors.initials: Y
authors.lastname: Hunag
authors.affiliation: Institute of Clinical Immunology, The First Affiliated Hospital of Soochow University, Suzhou, China.
authors.forename: Ruihua
authors.initials: R
authors.lastname: Chen
authors.affiliation: Department of Hematology and Oncology, Children's Hospital of Soochow University, Suzhou, 215003 China.
authors.forename: Shaoyan
authors.initials: S
authors.lastname: Hu
keywords: Acute lymphoblastic leukemia (ALL); CCLG-2008 protocol; Children; Mixed-phenotype acute leukemia (MPAL)