Clínica de Leucemia del Departamento de Hematología-Oncología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15 Sección XVI, Del Tlalpan, CP 14000, Mexico City, Federal District, Mexico.
Ann Hematol. 2014 Apr;93(4):595-601. doi: 10.1007/s00277-013-1919-6. Epub 2013 Oct 22.
Mixed phenotype acute leukemia (MPAL) in adults represents nearly 2 to 5 % of all acute leukemia cases. There are two large studies throughout the world and only case reports and small series have been reported in Latin America. This study retrospectively analyses the clinical characteristics and survival of 27 patients with MPAL evaluated in three medical institutions of Mexico. All cases meet World Health Organization 2008 criteria; 70.3 % of patients had B lymphoid/myeloid lineage MPAL. Induction chemotherapy protocols included 7 + 3 hyper-CVAD, high-density schedules, and pediatric-like regimens such as New York II and total XI. Complete remission was achieved in 23/27 patients (85.2 %). Only one patient died due to chemotherapy-induced aplasia during remission induction (5.2 %). In 68 % of cases, we were able to administer maintenance therapy as a regimen in lymphoblastic leukemia. At the time of analysis, 70.4 % of the patients in the entire cohort had died mainly as result of disease progression (73.6 %). Disease-free survival was 13 months (95 % CI, 9.6-16.3 months) and overall survival was 14.8 months (95 % CI 13.4-16.27). Survival rates are low and standardized therapy for the management of this type of leukemia is still lacking. This is the largest series reported in Mexico and to the best of our knowledge in Latin America.
成人混合表型急性白血病（MPAL）占所有急性白血病病例的近 2%至 5%。全球有两项大型研究，而拉丁美洲仅有病例报告和小系列报道。本研究回顾性分析了在墨西哥三家医疗机构评估的 27 例 MPAL 患者的临床特征和生存情况。所有病例均符合 2008 年世界卫生组织标准；70.3%的患者为 B 淋巴母细胞/髓系 MPAL。诱导化疗方案包括 7+3 高剂量 CVAD、高密度方案以及类似儿童的方案，如纽约 II 方案和全 XI 方案。27 例患者中有 23 例（85.2%）获得完全缓解。仅有 1 例患者在缓解诱导期间因化疗诱导的再生障碍而死亡（5.2%）。在 68%的病例中，我们能够作为淋巴细胞白血病的方案给予维持治疗。在分析时，整个队列中有 70.4%的患者主要因疾病进展而死亡（73.6%）。无病生存期为 13 个月（95%CI，9.6-16.3 个月），总生存期为 14.8 个月（95%CI 13.4-16.27）。生存率较低，针对这种类型白血病的标准化治疗仍缺乏。这是墨西哥报告的最大系列，也是我们所知的拉丁美洲最大系列。
