Optimal therapeutic strategies for mixed phenotype acute leukemia

Ofir Wolach*, Richard M. Stone

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

Abstract

Purpose of reviewMixed phenotype acute leukemia (MPAL) encompasses a rare group of clinically, immunophenotypically, and genetically diverse leukemias. Diagnosing and treating these patients remains challenging. In recent years, systematic efforts have been made to better define the genetic landscape of MPAL. These insights allow better understanding of the pathophysiology of MPAL, have the potential for a more biologically meaningful classification and may promote targeted, novel approaches to treat these leukemias.Recent findingsRecent studies suggest that MPALs originate in a multipotent primitive cell, demonstrate large genetic diversity and include subgroups that may benefit from targeted therapy. Recent data support the use of ALL-type induction followed by allogeneic stem cell transplantation in first remission for most adults. Novel targeted approaches hold promise for treatment of MPAL; however, some may unpredictably select for clonal expansion of cells from a different lineage than observed at presentation.SummaryA biologically and genetically driven classification of MPAL may yield more accurate prognosis and potentially direct therapy in patients with MPAL. Prospective efforts that incorporate targeted approaches based on genetics and immunophenotype are warranted.

Original languageEnglish
Pages (from-to)95-102
Number of pages8
JournalCurrent Opinion in Hematology
Volume27
Issue number2
DOIs
StatePublished - 1 Mar 2020
Externally publishedYes

Keywords

  • acute lymphoblastic leukemia-type therapy
  • allogeneic transplantation
  • genetic alterations
  • mixed phenotype acute leukemia
  • targeted therapy

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