Mixed Phenotype Acute Leukemia

Question 1

three symptoms associated with MPAL

Answer 1

• long lasting non productive cough (no improvement with antibiotics)
• fatigue, malaise, cervical lymphadenopathy, bruising

Question 2

definition of MPAL according to 2008 WHO classification

Answer 2

Defined as an acute leukemia showing either:

1. separate populations of blasts of more than one lineage
2. Single pop of blasts co-expressing antigens from more than one lineage simultaneously

Question 3

Common treatment options for MPAL

Answer 3

No standard treatment

• if AML, ALL, or combined: chemotherapies based on blast type
• TKI when Ph+
• Allogenic stem cell transplant when appropriate

Question 4

3 factors that negatively affect an MPAL patient’s prognosis

Answer 4

Ph+
Adult age
WBC > 14x10^9/L upon diagnosis

Question 5

Clinical symptoms of MPAL (be able to diagnose from symptoms and labs)

Answer 5

Symptoms: long-lasting non-productive cough, fatigue, malaise, cervical lymphadenopathy, bruising

Question 6

Lab findings of MPAL (be able to diagnose from symptoms and labs)

Answer 6

Leukocytosis 
>20% blasts 
Cytochemical staining 
Immunophenotyping by flow 
FISH analysis

Question 7

Clinical symptoms and Hematology findings:

MDS

Answer 7

This was objective but not in handout

Question 8

Clinical symptoms and Hematology findings:

AML

Answer 8

This was objective but not in handout

Question 9

Clinical symptoms and Hematology findings:

ALL

Answer 9

This was objective but not in handout