Allogeneic Hematopoietic Cell Transplantation for Patients with Mixed Phenotype Acute Leukemia

Reinhold Munker, Ruta Brazauskas, Hai Lin Wang, Marcos de Lima, Hanna J. Khoury, Robert Peter Gale, Richard T. Maziarz, Brenda M. Sandmaier, Daniel Weisdorf, Wael Saber

Research output: Contribution to journalArticlepeer-review

37 Scopus citations


Acute biphenotypic leukemias or mixed phenotype acute leukemias (MPAL) are rare and considered high risk. The optimal treatment and the role of allogeneic hematopoietic stem cell transplantation (alloHCT) are unclear. Most prior case series include only modest numbers of patients who underwent transplantation. We analyzed the outcome of 95 carefully characterized alloHCT patients with MPAL reported to the Center for International Blood and Marrow Transplant Research between 1996 and 2012. The median age was 20 years (range, 1 to 68). Among the 95 patients, 78 were in first complete remission (CR1) and 17 were in second complete remission (CR2). Three-year overall survival (OS) of 67% (95% confidence interval [CI], 57 to 76), leukemia-free survival of 56% (95% CI, 46 to 66), relapse incidence of 29% (95% CI, 20 to 38), and nonrelapse mortality of 15% (95% CI, 9 to 23) were encouraging. OS was best in younger patients (<20 years), but no significant differences were observed between those 20 to 40 years of age and those who were 40 years or older. A matched-pair analysis showed similar outcomes comparing MPAL cases to 375 acute myelogenous leukemia or 359 acute lymphoblastic leukemia cases. MPAL patients had more acute and a trend for more chronic graft-versus-host disease. No difference was observed between patients who underwent transplantation in CR1 versus those who underwent transplantation in CR2. AlloHCT is a promising treatment option for pediatric and adult patients with MPAL with encouraging long-term survival.

Original languageEnglish (US)
Pages (from-to)1024-1029
Number of pages6
JournalBiology of Blood and Marrow Transplantation
Issue number6
StatePublished - Jun 1 2016


  • Acute biphenotypic leukemia
  • Allogeneic transplantation
  • Mixed phenotype leukemia

ASJC Scopus subject areas

  • Hematology
  • Transplantation


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