Philadelphia chromosome‐positive mixed phenotype acute leukemia in the imatinib era
Although the introduction of imatinib dramatically improved the outcomes for patients with Philadelphia chromosome‐positive B‐cell precursor acute lymphoblastic leukemia (Ph+BCP‐ALL), the survival benefit of imatinib has not been assessed in the context of Ph+ mixed phenotype acute leukemia (Ph+MPAL). To clarify this important issue, we studied 42 Ph+ acute leukemia (Ph+AL) patients who received intensive chemotherapy and concurrent administration of imatinib. Of the 42 Ph+AL patients, 13 (31%) patients were categorized as Ph+MPAL (positive for both myeloid and B‐cell lineage), 27 (64%) were categorized as Ph+BCP‐ALL, and two (5%) were categorized as Ph+ acute myeloid leukemia. The complete remission rates after the initial induction therapy were not significantly different when comparing Ph+MPAL and Ph+BCP‐ALL patients (100% vs. 85%, respectively, P = 0.14). Likewise, there were no significant differences in the 5‐yr overall survival (OS) or disease‐free survival (DFS) rates when comparing the MPAL and BCP‐ALL groups (OS: 55% vs. 53%, respectively, P = 0.87, DFS: 46% vs. 42%, respectively, P = 0.94). These findings suggest that concurrent imatinib administration with chemotherapy improved the outcomes of Ph+MPAL patients to the level seen in Ph+BCP‐ALL patients and should, therefore, be considered as the standard therapy for these patients.
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