Meet The Professors: Acute Myeloid Leukemia Edition, 2017 (Video Program) - Video 27Initial management of mixed-phenotype acute leukemia
1:00 minutes.
TRANSCRIPTION:
DR LOVE: So Lyle, any questions you want to throw out? DR FEINSTEIN: Initial management of biphenotypic leukemia? DR STONE: So that’s a great question. I’ll refer you to my review article that I wrote with a brilliant Israeli colleague, Ofir Wolach in Blood, how I treat — it’s no longer called biphenotypic leukemia. It’s called mixed phenotype acute leukemia, MPAL. I just remind people that the 3 key factors for the myeloid/lymphoid lineage MPAL definition, it’s the myeloperoxidase by flow, cytochemistry or immunohistochemistry. For B lineage it’s CD19, and it’s cytoplasmic CD3 for T lineage. So if they have 2 of those, they’re mixed phenotype. Very important to rule out Philadelphia-positive disease, because they often have mixed phenotype. Once you’ve done that, I usually treat them like ALL, to make a long story short. We’ve combed the literature on this, and there’s no clear guidance. But all things being equal, if they have some lymphoid characteristics, we treat them like ALL and then transplant them. |