Cytogenetic abnormalities in acute leukaemia of ambiguous lineage: an overview

Manola, Kalliopi N.

doi:10.1111/bjh.12484

Cited by 51 publications

(54 citation statements)

References 59 publications

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“…Cytogenetic abnormalities in MPAL and BAL were reported in a recent systematic review to be present in 59% to 91% of patients. 30 The prevalence of Ph 1 and complex karyotype increases with age.…”

Section: Characteristics Of Mpalmentioning

confidence: 99%

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How I treat mixed-phenotype acute leukemia

Wolach

Stone

2015

Blood

138

139

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Mixed-phenotype acute leukemia (MPAL) encompasses a heterogeneous group of rare leukemias in which assigning a single lineage of origin is not possible. A variety of different terms and classification systems have been used historically to describe this entity. MPAL is currently defined by a limited set of lineage-specific markers proposed in the 2008 World Health Organization monograph on classification of tumors of hematopoietic and lymphoid tissues. In adult patients, MPAL is characterized by relative therapeutic resistance that may be attributed in part to the high proportion of patients with adverse cytogenetic abnormalities. No prospective, controlled trials exist to guide therapy. The limited available data suggest that an “acute lymphoblastic leukemia–like” regimen followed by allogeneic stem-cell transplant may be advisable; addition of a tyrosine kinase inhibitor in patients with t(9;22) translocation is recommended. The role of immunophenotypic and genetic markers in guiding chemotherapy choice and postremission strategy, as well as the utility of targeted therapies in non–Ph-positive MPALs is unknown.

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Section: Characteristics Of Mpalmentioning

confidence: 99%

“…30 One could argue that leukemia with CK or other myelodysplastic-specific cytogenetic abnormalities should be classified as AML with myelodysplasia-related changes rather than MPAL.…”

Section: Characteristics Of Mpalmentioning

confidence: 99%

How I treat mixed-phenotype acute leukemia

Wolach

Stone

2015

Blood

138

139

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“…Cytogenetic abnormalities may be seen in 59-91% of MPAL patients 23 . For MPAL, no pathognomonic cytogenetic change has been identified 2 .…”

Section: Cytogeneticsmentioning

confidence: 99%

Mixed-phenotype acute leukemia: state-of-the-art of the diagnosis, classification and treatment

Čerňan¹,

Szotkowski²,

Pikalova³

2017

BIOMED PAP

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Mixed-phenotype acute leukemia (MPAL) is a heterogeneous group of hematopoietic malignancies in which blasts show markers of multiple developmental lineages and cannot be clearly classified as acute myeloid or lymphoblastic leukemias. Historically, various names and classifications were used for this rare entity accounting for 2-5% of all acute leukemias depending on the diagnostic criterias used. The currently valid classification of myeloid neoplasms and acute leukemia published by the World Health Organization (WHO) in 2016 refers to this group of diseases as MPAL. Because adverse cytogenetic abnormalities are frequently present, MPAL is generally considered a disease with a poor prognosis. Knowledge of its treatment is limited to retrospective analyses of small patient cohorts. So far, no treatment recommendations verified by prospective studies have been published. The reported data suggest that induction therapy for acute lymphoblastic leukemia followed by allogeneic hematopoietic cell transplantation is more effective than induction therapy for acute myeloid leukemia or consolidation chemotherapy. The establishment of cooperative groups and international registries based on the recent WHO criterias are required to ensure further progress in understanding and treatment of MPAL. This review summarizes current knowledge on the diagnosis, classification, prognosis and treatment of MPAL patients.

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Section: Insufficientmentioning

confidence: 99%

Initial Diagnostic Workup of Acute Leukemia: Guideline From the College of American Pathologists and the American Society of Hematology

Arber¹,

Borowitz²,

Cessna³

et al. 2017

Archives of Pathology &Amp; Laboratory Medicine

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Context.-A complete diagnosis of acute leukemia requires knowledge of clinical information combined with morphologic evaluation, immunophenotyping and karyotype analysis, and often, molecular genetic testing. Although many aspects of the workup for acute leukemia are well accepted, few guidelines have addressed the different aspects of the diagnostic evaluation of samples from patients suspected to have acute leukemia.Objective.-To develop a guideline for treating physicians and pathologists involved in the diagnostic and prognostic evaluation of new acute leukemia samples, including acute lymphoblastic leukemia, acute myeloid leukemia, and acute leukemias of ambiguous lineage.Design.-The College of American Pathologists and the American Society of Hematology convened a panel of experts in hematology and hematopathology to develop recommendations. A systematic evidence review was conducted to address 6 key questions. Recommendations were derived from strength of evidence, feedback received during the public comment period, and expert panel consensus.Results.-Twenty-seven guideline statements were established, which ranged from recommendations on what clinical and laboratory information should be available as part of the diagnostic and prognostic evaluation of acute leukemia samples to what types of testing should be performed routinely, with recommendations on where such testing should be performed and how the results should be reported.Conclusions.-The guideline provides a framework for the multiple steps, including laboratory testing, in the evaluation of acute leukemia samples. Some aspects of the guideline, especially molecular genetic testing in acute leukemia, are rapidly changing with new supportive literature, which will require on-going updates for the guideline to remain relevant.

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Cytogenetic abnormalities in acute leukaemia of ambiguous lineage: an overview

Cited by 51 publications

References 59 publications

How I treat mixed-phenotype acute leukemia

How I treat mixed-phenotype acute leukemia

Mixed-phenotype acute leukemia: state-of-the-art of the diagnosis, classification and treatment

Initial Diagnostic Workup of Acute Leukemia: Guideline From the College of American Pathologists and the American Society of Hematology

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