Mixed-phenotype acute leukemia: A cohort and consensus research strategy from the Children's Oncology Group Acute Leukemia of Ambiguous Lineage Task Force

被引：37

作者：

Orgel, Etan ^{[1
,2
]}

Alexander, Thomas B. ^{[3
]}

Wood, Brent L. ^{[4
]}

Kahwash, Samir B. ^{[5
]}

Devidas, Meenakshi ^{[6
]}

Dai, Yunfeng ^{[7
]}

Alonzo, Todd A. ^{[8
]}

Mullighan, Charles G. ^{[9
]}

Inaba, Hiroto ^{[10
]}

Hunger, Stephen P. ^{[11
,12
,13
]}

Raetz, Elizabeth A. ^{[14
]}

Gamis, Alan S. ^{[15
]}

Rabin, Karen R. ^{[16
]}

Carroll, Andrew J. ^{[17
]}

Heerema, Nyla A. ^{[18
]}

Berman, Jason N. ^{[19
,20
]}

Woods, William G. ^{[21
]}

Loh, Mignon L. ^{[22
,23
]}

Zweidler-McKay, Patrick A. ^{[24
]}

Horan, John T. ^{[21
]}

机构：

[1] Childrens Hosp Los Angeles, Dept Pediat, Los Angeles, CA 90027 USA

[2] Univ Southern Calif, Dept Pediat, Los Angeles, CA USA

[3] Univ N Carolina, Dept Pediat, Chapel Hill, NC 27515 USA

[4] Univ Washington, Dept Lab Med & Pathol, Seattle, WA 98195 USA

[5] Nationwide Childrens Hosp, Dept Pathol & Lab Med, Columbus, OH USA

[6] St Jude Childrens Res Hosp, Dept Global Pediat Med, 332 N Lauderdale St, Memphis, TN 38105 USA

[7] Univ Florida, Dept Biostat, Gainesville, FL USA

[8] Univ Southern Calif, Dept Prevent Med, Los Angeles, CA USA

[9] St Jude Childrens Res Hosp, Dept Pathol, 332 N Lauderdale St, Memphis, TN 38105 USA

[10] St Jude Childrens Res Hosp, Dept Oncol, 332 N Lauderdale St, Memphis, TN 38105 USA

[11] Childrens Hosp Philadelphia, Dept Pediat, Philadelphia, PA 19104 USA

[12] Childrens Hosp Philadelphia, Ctr Childhood Canc Res, Philadelphia, PA 19104 USA

[13] Univ Penn, Perelman Sch Med, Philadelphia, PA 19104 USA

[14] NYU Langone Hlth, Dept Pediat, New York, NY USA

[15] Childrens Mercy Canc Ctr, Dept Pediat, Kansas City, MO USA

[16] Baylor Coll Med, Dept Pediat, Houston, TX 77030 USA

[17] Univ Alabama Birmingham, Dept Genet, Birmingham, AL USA

[18] Ohio State Univ, Coll Med, Dept Pathol, Wexner Med Ctr, Columbus, OH 43210 USA

[19] Univ Ottawa, Dept Pediat, Ottawa, ON, Canada

[20] Univ Ottawa, CHEO Res Inst, Ottawa, ON, Canada

[21] Emory Univ, Childrens Healthcare Atlanta, Aflac Canc & Blood Disorders Ctr, Atlanta, GA 30322 USA

[22] Univ Calif San Francisco, Dept Pediat, Benioff Childrens Hosp, San Francisco, CA USA

[23] Univ Calif San Francisco, Helen Diller Comprehens Canc Ctr, San Francisco, CA USA

[24] ImmunoGen Inc, Waltham, MA USA

来源：

CANCER | 2020年 / 126卷 / 03期

关键词：

acute leukemia of ambiguous lineage; biphenotypic acute leukemia; hematopoietic stem cell transplantation; mixed-phenotype acute leukemia; pediatric leukemia; ISOLATED MYELOPEROXIDASE EXPRESSION; STEM-CELL TRANSPLANTATION; WORLD-HEALTH-ORGANIZATION; RELAPSE RISK; T-CELL; CLASSIFICATION; OUTCOMES; SURVIVAL; THERAPY;

D O I：

10.1002/cncr.32552

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background Optimal 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. Methods To 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. Results The 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). Conclusions The 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.

引用

页码：593 / 601

页数：9

共 32 条

[21] Mixed-phenotype acute leukemia: suboptimal treatment when the 2008/2016 WHO classification is used [J].

Pomerantz, Alan ;

Rodriguez-Rodriguez, Sergio ;

Demichelis-Gomez, Roberta ;

Barrera-Lumbreras, Georgina ;

Barrales-Benitez, Olga ;

Lopez-Karpovitch, Xavier ;

Aguayo-Gonzalez, Alvaro .

BLOOD RESEARCH, 2016, 51 (04) :233-241

[22] Isolated myeloperoxidase expression in pediatric B/myeloid mixed phenotype acute leukemia is linked with better survival [J].

Raikar, Sunil S. ;

Park, Sunita I. ;

Leong, Traci ;

Jaye, David L. ;

Keller, Frank G. ;

Horan, John T. ;

Woods, William G. .

BLOOD, 2018, 131 (05) :573-577

[23] Acute mixed lineage leukemia in children: the experience of St Jude Children's Research Hospital [J].

Rubnitz, Jeffrey E. ;

Onciu, Mihaela ;

Pounds, Stanley ;

Shurtleff, Sheila ;

Cao, Xueyuan ;

Raimondi, Susana C. ;

Behm, Frederick G. ;

Campana, Dario ;

Razzouk, Bassem I. ;

Ribeiro, Raul C. ;

Downing, James R. ;

Pui, Ching-Hon .

BLOOD, 2009, 113 (21) :5083-5089

[24] Late MRD response determines relapse risk overall and in subsets of childhood T-cell ALL: results of the AIEOP-BFM-ALL 2000 study [J].

Schrappe, Martin ;

Valsecchi, Maria Grazia ;

Bartram, Claus R. ;

Schrauder, Andre ;

Panzer-Gruemayer, Renate ;

Moericke, Anja ;

Parasole, Rosanna ;

Zimmermann, Martin ;

Dworzak, Michael ;

Buldini, Barbara ;

Reiter, Alfred ;

Basso, Giuseppe ;

Klingebiel, Thomas ;

Messina, Chiara ;

Ratei, Richard ;

Cazzaniga, Giovanni ;

Koehler, Rolf ;

Locatelli, Franco ;

Schaefer, Beat W. ;

Arico, Maurizio ;

Welte, Karl ;

van Dongen, Jacques J. M. ;

Gadner, Helmut ;

Biondi, Andrea ;

Conter, Valentino .

BLOOD, 2011, 118 (08) :2077-2084

[25] Survival of patients with mixed phenotype acute leukemias: A large population-based study [J].

Shi, Runhua ;

Munker, Reinhold .

LEUKEMIA RESEARCH, 2015, 39 (06) :606-616

[26] Allogeneic hematopoietic stem cell transplantation for adult patients with mixed phenotype acute leukemia: results of a matched-pair analysis [J].

Shimizu, Hiroaki ;

Saitoh, Takayuki ;

Machida, Shinichiro ;

Kako, Shinichi ;

Doki, Noriko ;

Mori, Takehiko ;

Sakura, Toru ;

Kanda, Yoshinobu ;

Kanamori, Heiwa ;

Miyawaki, Shuichi ;

Okamoto, Shinichiro .

EUROPEAN JOURNAL OF HAEMATOLOGY, 2015, 95 (05) :455-460

[27] Integrative genomic analysis of adult mixed phenotype acute leukemia delineates lineage associated molecular subtypes [J].

Takahashi, Koichi ;

Wang, Feng ;

Morita, Kiyomi ;

Yan, Yuanqing ;

Ho, Peter ;

Zhao, Pei ;

Abou Zhar, Abdallah ;

Wu, Chang Jiun ;

Gumbs, Curtis ;

Little, Latasha ;

Tippen, Samantha ;

Thornton, Rebecca ;

Coyle, Marcus ;

Mendoza, Marisela ;

Thompson, Erika ;

Zhang, Jianhua ;

DiNardo, Courtney D. ;

Jain, Nitin ;

Ravandi, Farhad ;

Cortese, Jorge E. ;

Garcia-Manero, Guillermo ;

Kornblau, Steven ;

Andreeff, Michael ;

Jabbour, Elias ;

Bueso-Ramos, Carlos ;

Takaori-Kondo, Akifumi ;

Konopleva, Marina ;

Patel, Keyur ;

Kantarjian, Hagop ;

Futreal, P. Andrew .

NATURE COMMUNICATIONS, 2018, 9

[28] Comparison of outcomes in mixed phenotype acute leukemia patients treated with chemotherapy and stem cell transplantation versus chemotherapy alone [J].

Tian, Hong ;

Xu, Yang ;

Liu, Liming ;

Yan, Lingzhi ;

Jin, Zhengming ;

Tang, Xiaowen ;

Han, Yue ;

Fu, Zhengzheng ;

Qiu, Huiying ;

Sun, Aining ;

Wu, Depei .

LEUKEMIA RESEARCH, 2016, 45 :40-46

[29] Acute leukemias of ambiguous lineage: diagnostic consequences of the WHO2008 classification [J].

van den Ancker, W. ;

Terwijn, M. ;

Westers, T. M. ;

Merle, P. A. ;

van Beckhoven, E. ;

Drager, A. M. ;

Ossenkoppele, G. J. ;

van de Loosdrecht, A. A. .

LEUKEMIA, 2010, 24 (07) :1392-1396

[30] Mixed-phenotype acute leukemia: historical overview and a new definition [J].

Weinberg, O. K. ;

Arber, D. A. .

LEUKEMIA, 2010, 24 (11) :1844-1851

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