Mixed-phenotype acute leukemia: suboptimal treatment when the 2008/2016 WHO classification is used
Autor: | Olga Barrales-Benitez, Alan Pomerantz, Sergio Rodríguez-Rodríguez, Georgina Barrera-Lumbreras, Xavier López-Karpovitch, Roberta Demichelis-Gómez, and Alvaro Aguayo-Gonzalez |
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Jazyk: | angličtina |
Rok vydání: | 2016 |
Předmět: |
Chemotherapy
medicine.medical_specialty Acute leukemia WHO classification Mixed phenotype acute leukemia Mixed-phenotype acute leukemia business.industry medicine.medical_treatment Suboptimal treatment Myeloid leukemia Hematology World health EGIL classification 03 medical and health sciences 0302 clinical medicine 030220 oncology & carcinogenesis Internal medicine Medicine In patient Who criteria Original Article business Who classification 030215 immunology |
Zdroj: | Blood research |
ISSN: | 2288-0011 2287-979X |
Popis: | Background Different criteria have been used to diagnose mixed-phenotype acute leukemia (MPAL), which has impacted the number of individuals diagnosed with this pathology. Better outcomes have been reported when using acute lymphoblastic leukemia (ALL)-type chemotherapy in the treatment of MPAL. Methods We compared the outcome of 4 groups of patients with MPAL. Group 1 included patients diagnosed using the 2008/2016 World Health Organization (WHO) classification; group 2 included patients diagnosed using the European Group for the Immunological Characterization of Leukemias (EGIL) criteria; group 3 included patients diagnosed using either the EGIL or the 2008/2016 WHO criteria; and group 4 was comprised of patients diagnosed with MPAL using the EGIL classification only. Results We found a significantly worse disease-free survival (groups 1-4) and overall survival (OS) (groups 2 and 3) when comparing MPAL patients to other acute leukemia (AL) patients. A significantly better OS was obtained in patients (groups 2-4) treated with ALL-type chemotherapy compared to acute myeloid leukemia (AML)-type regimens. Conclusion In light of these results, and because a trend (P=0.06) was found with regard to a better OS in group 4 when compared to other AL patients, an argument can be made that the 2008/2016 WHO classification is underpowered to diagnose all MPAL cases, potentially resulting in the suboptimal treatment of some individuals with AL. |
Databáze: | OpenAIRE |
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