JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES) ›› 2017, Vol. 55 ›› Issue (2): 79-83.doi: 10.6040/j.issn.1671-7554.0.2015.533

Previous Articles     Next Articles

Clinical characteristics and prognosis of 48 patients with mixed phenotype acute leukemia

ZHOU Lanlan, PAN Xueyi, GUO Yu   

  1. Heamotology Department of the First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou 510080, Guangdong, China
  • Received:2015-06-01 Online:2017-02-10 Published:2017-02-10

Abstract: Objective To investigate the clinical and biological characteristics and prognosis of mixed phenotype acute leukemia(MPAL). Methods Forty-eight patients diagnosed with MPAL(MPAL group)by WHO 2008 criteria and 50 patients diagnosed with Ly+AML(Ly+AML group), which is defined as the control group, in the same period were retrospectively analyzed. The cell morphology analysis was performed by swiss and cytochemical staining, the cell immunophenotype was detected by the flow cytometry, the fusion gene of leukemia was detected by fluorescence in situ hybridization, and the chromosome karyotype was analyzed by the standard technique of G-banding. Results The median age of MPAL group was larger than that of Ly+AML group significantly(54 y vs 30 y, P<0.05). The incidence of CD34 positive expression, bnormal karyotype and ph+ in the MPAL group were significantly higher than those in the Ly+AML group(85.4% vs 50%, 65.3% vs 35.7%, 23% vs 0%, all P<0.05). The OS and RFS of MPAL group were significantely lower than those of Ly+AML group(both P<0.05). Conclusion Compared with Ly+AML group, MPAL group has lower OS and RFS; the poor prognosis of MPAL may due to the age, and high incidence of CD34 positive expression and ph+.

Key words: Mixed phenotype acute leukemia, Prognosis, Immunotyping

CLC Number: 

  • R551.3
[1] Van den Ancker W, Terwijn M, Westers TM, et al. Acute leukemias of ambiguous lineage: diagnostic consequences of the WHO2008 classification[J]. Leukemia, 2010, 24(7): 1392-1396.
[2] Bene M, Bernier M, Casasnovas RO, et al. The reliability and specificity of c-kit for the diagnosis of acute myeloid leukemias and undifferentiated leukemias[J]. Blood, 1998, 92(2): 596-599.
[3] 张之南,沈悌.血液病诊断及疗效标准[M]. 3版. 北京: 科学技术出版社, 2007: 131-134.
[4] 张彦明,吴德沛,孙爱宁,等.混合表型急性白血病32例临床研究[J].中华血液学杂志, 2011, 32(1): 12-16. ZHANG Yanming, WU Depei, SUN Aining, et al. Study on the clinical characteristics of 32 pafients with mixed phenotype acute leukemia[J]. Chin Hematol, 2011, 32(1): 12-16.
[5] Matutes E, Pickl WF, Vant Veer M, et al. Mixed-phenotype acute leukemia: clinical and laboratory features and outcome in 100 patients defined according to the WHO 2008 classification[J]. Blood, 2011, 117(11): 3163-3171.
[6] Gritsaev SV, Kostroma II, Riadnova GM, et al. The specific features of diagnosis of mixed-phenotype acute leukemia: a combination of B-cell antigen expressions according to the results of flow cytometry and morphological markers of myeloid differentiation in blast cells: a clinical case[J]. Ter Arkh, 2015, 87(7): 97-100.
[7] 杨芝红,洪燕燕. 流式细胞术诊断急性混合细胞白血病临床意义研究[J].中国现代医学杂志, 2013, 23(5): 67-71. YANG Zhihong, HONG Yanyan. Diagnostic value of flow cytometry in patients with acute mixed-lineage leukemia[J]. China Journal of Modern Medicine, 2013, 23(5): 67-71.
[8] 邓小娟,彭贤贵,王平,等. 急性混合细胞白血病的形态学、免疫学及细胞遗传学观察[J].国际输血及血液学杂志, 2014, 37(1): 29-31.
[9] 赵广芬,黄先豹,陈艳,等.急性混合细胞白血病44例的诊治分析[J].实用医学杂志, 2012, 28(3): 448-450.
[10] Marcela DC, Martha AI, Guillermo J, et al. Diagnosing and treating mixed phenotype acute leukemia: a multicenter 10-year experience in Mexico[J]. Ann Hematol, 2014, 93(4): 595-601.
[11] Shi R, Munker R. Survival of patients with mixed phenotype acute leukemias: a large population-based study[J]. Leuk Res, 2015, 39(6): 606-616.
[12] Weinberg OK, Seetharam M, Ren L, et al. Mixed phenotype acute leukemia: a study of 61 cases using World Health Organization and European Group for the Immunological Classification of Leukaemias criteria[J]. Am J Clin Pathol, 2014, 142(6): 803-808.
[13] Bachir F, Zerrouk J, Howard SC, et al. Outcomes in patients with mixed phenotype acute leukemia in Morocco[J]. J Pediatr Hematol Oncol, 2014, 36(6): 392-397.
[14] Lee JH, Min YH, Chung CW, et al. Prognostic implications of the immunophenotype in biphenotypic acute leukemia[J]. Leukemia & Lymphoma, 2008, 49(4): 700-709.
[15] Yan L, Ping N, Zhu M, et al. Clinical, immunophenotypic, cytogenetic, and molecular genetic features in 117 adult patients with mixed-phenotype acute leukemia defined by WHO-2008 classification[J]. Haematologica, 2012, 97(11): 1708-1712.
[16] Atfy M, Al Azizi NM, Elnaggar AM, et al. Incidence of Philadelphia-chromosome in acute myelogenous leukemia and biphenotypic acute leukemia patients: And its role in their outcome[J]. Leuk Res, 2011, 35(10): 1339-1344.
[17] 赵林艳,周结,龚芳,等.异基因造血干细胞移植治疗16例混合表型急性白血病患者临床疗效观察[J]. 中华血液学杂志, 2015, 36(11): 963-965. ZHAO Linyan, ZHOU Jie, GONG Fang, et al. Clinical efficacy observation of allogeneic hematopoietic stem cell transplantation in 16 patients with mixed phenotype acute leukemia[J]. Chin Hematol, 2015, 36(11): 963-965.
[18] Xu XQ, Wang JM, Lu SQ, et al. Clinical and biological characteristics of adult biphenotypic acute leukemia in comparison with that of acute myeloidleukemia and acute lymphoblastic leukemia: a case series of a Chinese population[J]. Haematologica, 2009, 94(7): 919-927.
[19] Eckstein OS, Wang L, Punia JN, et al. Mixed-phenotype acute leukemia(MPAL)exhibits frequent mutations in DNMT3A and activated signaling genes[J]. Exp Hematol, 2016, 44(8): 740-744.
[20] Weinberg OK, Arber DA. Mixed-phenotype acute leukemia: historical overview and a new definition[J]. Leukemia, 2010, 24(11): 1844-1851.
[21] Lee JY, Lee SM, Lee JY, et al. Mixed-phenotype acute leukemia treated with decitabine[J]. Korean J Intern Med, 2016, 31(2): 406-408.
[22] Stone RM. Transplantation after remission in mixed phenotype acute leukemia: a good idea[J]. Biol Blood Marrow Transplant, 2016, 22(6): 971-972.
[23] 颜灵芝,陈苏宁,平娜娜,等.15例成人Ph染色体和/或BCR-ABL阳性混合表型急性白血病的临床及实验室特征分析[J]. 中华实验血液学杂志, 2013, 21(5): 1116-1120. YAN Lingzhi, CHEN Suning, PING Nana, et al. Clinical and laboratorial analysis for 15 adult cases of mixed phenotypic acute leukemia with Ph chromosome and/or positive BCR-ABL[J]. Journal of Experimental Hematology, 2013, 21(5): 1116-1120.
[24] Tian H, Xu Y, Liu L, et al. Comparison of outcomes in mixed phenotype acute leukemiapatients treated with chemotherapy and stem cell transplantation versus chemotherapy alone[J]. Leuk Res, 2016, 45: 40-46.
[25] Munker R, Brazauskas R, Wang HL, et al. Allogeneic hematopoietic cell transplantation for patients with mixed phenotype acute leukemia[J]. Biol Blood Marrow Transplant, 2016, 22(6): 1024-1029.
[1] LI Yinglin, SONG Daoqing, XU Zhonghua. Identification of FKBP11 expression in clear cell renal cell carcinoma using bioinformatics analysis [J]. Journal of Shandong University (Health Sciences), 2020, 1(9): 45-51.
[2] SHI Shuang, LI Juan, MI Qi, WANG Yunshan, DU Lutao, WANG Chuanxin. Construction and application of a miRNAs prognostic risk assessment model of gastric cancer [J]. Journal of Shandong University (Health Sciences), 2020, 1(7): 47-52.
[3] LI Xingkai, LIU Zhanye, JIANG Yunfeng, LI Jun. Clinicopathological factors and prognosis between primary central and peripheral lung squamous cell carcinoma [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(9): 73-78.
[4] ZONG Shuai, XIAO Dongjie, LIU Hua, JIA Yanfei, MA Xiaoli, LI Huanjie, LI Ping, ZHENG Yan, WANG Yunshan. Expression of CSN5 and its correlation with the prognosis of gastric carcinoma [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(7): 12-16.
[5] SUN Qijing, CHEN Fangfang, LI Chunxiao, ZHANG Caiqing. Clinical value of PNI and HGB in evaluating the prognosis of the middle to late stage non-small cell lung cancer patients [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(4): 55-59.
[6] LIN Jiaxiang, GUO Zijia, SU Peng, WANG Xiao, GUO Yaxin, WU Xiaojuan, XIANG Lei, ZHOU Zhiqiang, WANG Yan, CUI Xiujie, PAN Aifeng, GUO Chenghao. The role of CIP2A in the transformation of breast ductal epithelium and prognosis of invasive breast cancer [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(3): 100-106.
[7] ZHANG Xiying, ZHAI Chunyan, LI Jingsong, HAN Bo. Expression of EZH2 in Chinese Ewing sarcoma patients and its relationship with clinicopathological parameters and prognosis [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(2): 84-91.
[8] LIU Huiling, WANG Xingwen, FENG Shaobin, FENG Hong, HAN Junqing. Association between high expression of scavenger receptor class B type I and the prognosis of colon cancer [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(10): 84-89.
[9] LI Xiaoning, CUI Lianqun. Treatment timing of non-infarct-related artery in patients with multi-vessel disease and acute myocardial infarction [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(8): 50-54.
[10] WANG Wen, LIU Yao, LONG Fei, MA Weixia, SU Lili. Correlation between lymphocyte-to-monocyte ratio in peripheral blood and prognosis of malignant pleural mesothelioma [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(8): 72-77.
[11] LIU Tong, ZHANG Xin, WANG Chuanxin. Significance of IRX5 mRNA in the diagnosis and prognosis of colorectal cancer [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(7): 69-74.
[12] MA Lin, ZHANG Dong, TANG Lei, YE Siyuan, YAN Chuanzhu, CAO Lili. Prognostic hematological biomarkers of amyotrophic lateral sclerosis [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(4): 46-50.
[13] XU Zhihong, WU Xiaohua, YAO Tiezhu, WANG Xiaoxiang, DUAN Xiaoyang, SHI Jian. Relationship between mir-99a expression and prognosis of epithelial ovarian cancer [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(3): 77-80.
[14] QU Lixin, SHI Xinghua, DU Yifeng. Relationship between circulating platelets microparticles and endothelial microparticls and prognosis in patients with acute ischemic stroke [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(12): 32-36.
[15] LIU Xiao, LIU Zhiguang, FAN Zhisong, WANG Yuan, YANG Xingxiao, KONG Jieyu, CHEN Junzhuo, LIU Junxia. Prognostic analysis of patients with severe sepsis and septic shock [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(10): 80-84.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!