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Outcomes of allogeneic hematopoietic cell transplantation in patients with biphenotypic acute leukemia

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Abstract

The outcomes of allogeneic hematopoietic cell transplantation (HSCT) in patients with biphenotypic acute leukemia (BAL) remain unclear. We retrospectively analyzed the outcomes of HSCT in BAL patients in Japan in comparison to acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL) using the registration data from a nationwide database. The data of 90, 5371, and 3301 patients with BAL, AML, and ALL, respectively, were included in the analysis. The median follow-up period was 1481.5 days (range: 0–5556). The 5-year overall survival (OS) of the BAL, AML, and ALL patients were 39.6, 41.8, and 42.0 %, respectively (BAL vs. AML, P = 0.98 BAL vs. ALL, P = 0.77). A multivariate analysis revealed that, in comparison to BAL, AML with a better-risk karyotype was associated with superior OS. An analysis of the prognostic factors of BAL patients showed that OS was significantly longer in patients who were in their first complete remission in comparison to patients who were not in remission. Our data suggest that HSCT is an effective treatment for BAL patients, regardless of the presence of any known poor prognostic factors other than a non-remission status.

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References

  1. Al-Seraihy AS, Owaidah TM, Ayas M, El-Solh H, Al-Mahr M, Al-Ahmari A et al (2009) Clinical characteristics and outcome of children with biphenotypic acute leukemia. Haematologica 94:1682–90

    Article  PubMed  PubMed Central  Google Scholar 

  2. Bene MC, Castoldi G, Knapp W, Ludwig WD, Matutes E, Orfao A et al (1995) Proposals for the immunological classification of acute leukemias. European Group for the Immunological Characterization of Leukemias (EGIL). Leukemia 9:1783–6

    PubMed  CAS  Google Scholar 

  3. Swerdlow SH, Campo E, Harris NL et al (2008) E. No Title. WHO Classif. Tumours Haematop. Lymphoid Tissues

  4. Legrand O, Perrot JY, Simonin G, Baudard M, Cadiou M, Blanc C et al (1998) Adult biphenotypic acute leukaemia: an entity with poor prognosis which is related to unfavourable cytogenetics and P-glycoprotein over-expression. Br J Haematol 100:147–55

    Article  PubMed  CAS  Google Scholar 

  5. Xu X-Q, Wang J-M, Lü S-Q, Chen L, Yang J-M, Zhang W-P et al (2009) Clinical and biological characteristics of adult biphenotypic acute leukemia in comparison with that of acute myeloid leukemia and acute lymphoblastic leukemia: a case series of a Chinese population. Haematologica 94:919–27

    Article  PubMed  PubMed Central  Google Scholar 

  6. Shimizu H, Saitoh T, Machida S, Kako S, Doki N, Mori T et al (2015) Allogeneic hematopoietic stem cell transplantation for adult patients with mixed phenotype acute leukemia: results of a matched-pair analysis. Eur J Haematol

  7. NCCN guidelines version2.2014 Acute Myeloid Leukemia.: http://www.nccn.org/professionals/physician_gls/pdf/aml.pdf. Accecced 27 April 2015

  8. Storer BE (1999) Estimation of failure probabilities in the presence of competing risks: new representations of old estimators. 706:695–706

  9. Fine JP, Gray RJ (1999) A proportional hazards model for the subdistribution of a competing risk. J Am Stat Assoc 94:496–509

    Article  Google Scholar 

  10. Kanda Y (2013) Investigation of the freely available easy-to-use software “EZR” for medical statistics. Bone Marrow Transplant 48:452–8

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  11. Miyawaki S (2012) Clinical studies of acute myeloid leukemia in the Japan Adult Leukemia Study Group. Int J Hematol 96:171–7

    Article  PubMed  Google Scholar 

  12. Yan L, Ping N, Zhu M, Sun A, Xue Y, Ruan C et al (2012) Clinical, immunophenotypic, cytogenetic, and molecular genetic features in 117 adult patients with mixed-phenotype acute leukemia defined by WHO-2008 classification. Haematologica 97:1708–12

    Article  PubMed  PubMed Central  Google Scholar 

  13. Killick S, Matutes E, Powles RL, Hamblin M, Swansbury J, Treleaven JG et al (1999) Outcome of biphenotypic acute leukemia. Haematologica 84:699–706

    PubMed  CAS  Google Scholar 

  14. Carbonell F, Swansbury J, Min T, Matutes E, Farahat N, Buccheri V et al (1996) Cytogenetic findings in acute biphenotypic leukaemia. Leukemia 10:1283–7

    PubMed  CAS  Google Scholar 

  15. Thalhammer-scherrer R, Mitterbauer G, Simonitsch I (2002) The immunophenotype of 325 adult acute leukemias relationship to morphologic and molecular classification and proposal for a minimal screening program highly predictive for lineage discrimination. 380–9

  16. Owaidah TM, Al Beihany A, Iqbal MA, Elkum N, Roberts GT (2006) Cytogenetics, molecular and ultrastructural characteristics of biphenotypic acute leukemia identified by the EGIL scoring system. Leukemia 20:620–6

    Article  PubMed  CAS  Google Scholar 

  17. Weir EG, Ali Ansari-Lari M, Batista DAS, Griffin CA, Fuller S, Smith BD et al (2007) Acute bilineal leukemia: a rare disease with poor outcome. Leukemia 21:2264–70

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Jinichi Mori.

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This study was approved by the ethical committee of Tokyo Metropolitan Otsuka Hospital and the Committee for Nationwide Survey Data Management of the JSHCT (approval number 2–20).

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The authors declare no conflicts of interest in association with the present study.

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No financial or material support was received for this study.

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Mori, J., Ishiyama, K., Yamaguchi, T. et al. Outcomes of allogeneic hematopoietic cell transplantation in patients with biphenotypic acute leukemia. Ann Hematol 95, 295–300 (2016). https://doi.org/10.1007/s00277-015-2536-3

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  • DOI: https://doi.org/10.1007/s00277-015-2536-3

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