Allogeneic HCT for Acute Biphenotypic Leukemias

Acute biphenotypic leukemias (ABiL) are rare, representing just 2-5% of all acute leukemias, and as such, optimal treatment approaches are not well established. But new research presented at the BMT Tandem Meetings on transplants in patients with ABiL has found that 3-year overall survival (OS) in these patients is 65%, leading researchers to conclude that “allogeneic HCT is a valid treatment option for patients with ABiL and should be explored in patients without significant comorbidities.”

In this retrospective analysis, researchers analyzed 84 patients <70 years old with ABiL whose transplant outcomes were reported to CIBMTR (Center for International Blood and Marrow Transplant Research). Median age of patients was 19 years, and all transplants were performed between 1996 and 2013 at 48 transplant centers in 8 countries.

Thirty-six percent of patients received bone marrow, 33% received peripheral blood stem cells, and 31% received cord blood grafts. At one year post-transplant, transplant-related mortality was 15%, three-year overall survival was 65%, and three-year disease-free survival was 60%.

There was no difference in 3-year overall survival among patients transplanted in first or second complete remission: 65% vs. 69%, respectively. Patients with normal/intermediate cytogenetics (n=44) and those with bcr/abl+/poor cytogenetics (n=27) had comparable 3-year survival rates: 62% vs. 70%, respectively.

Lead researcher Dr. Reinhold Munker of Louisiana State University concluded that allogeneic transplant should be considered in patients with ABiL who do not have significant comorbidities.

Munker R, et al. Biol Blood Marrow Transplant