{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T16:02:43Z","timestamp":1772035363892,"version":"3.50.1"},"reference-count":45,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,3]]},"abstract":"\n Purpose:<\/jats:title>\n Mixed phenotype acute leukemia (MPAL) represents an uncommon but heterogenous disease, often posing both a diagnostic and therapeutic challenge. The purpose of this retrospective study was to analyze the overall survival, event-free survival, and severity of associated complications after allo-HSCT in children with MPAL, and provide feasible recommendations for the treatment of MPAL patients.<\/jats:p>\n <\/jats:sec>\n \n Patients and Methods:<\/jats:title>\n We retrospectively analyzed a total of 14 pediatric patients with MPAL who received allo-HSCT at our center between January 2010 and June 2024.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n In terms of immunophenotype, coexpression of myeloid and B-lymphoid antigens was observed in 10 patients (71.4%), and myeloid and T-lymphoid antigens in 4 (28.6%). Chromosomal abnormalities were found in 8 patients (57.1%) and\n BCR\/ABL(+)<\/jats:italic>\n was the most common fusion gene (3\/14; 21.4%). All 14 patients underwent allo-HSCT after achieving the CR1 (78.6% with MRD-negative status pretransplantation). Among the 14 transplanted children, the OS rate was 92.9% and the EFS rate was 85.7%. No significant difference in OS, EFS, and CIR rates between children with Haplo-HSCT and those with MSD-HSCT (\n P<\/jats:italic>\n >0.05). The rate of acute GVHD was 57.1% (8\/14), and the rate of chronic GVHD was 71.4%, of which 90% were assessed as mild cGVHD, with the skin being the most common organ involved in cGVHD. Only one patient developed TA-TMA and died from transplant-related complications.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n The children with MPAL who received allo-HSCT after MRD-negative CR often had a favorable disease control. Compared with patients receiving conventional chemotherapy, pediatric patients who received allo-HSCT showed a significant improvement in OS, EFS, and CIR rates. Although the incidence of cGVHD was relatively high, most of them were assessed as mild with no significant impact on daily activities.<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/mph.0000000000003166","type":"journal-article","created":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T15:00:29Z","timestamp":1772031629000},"page":"e69-e77","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Allogeneic Hematopoietic Stem Cell Transplantation for Children With Mixed Phenotype Acute Leukemia: A Single-Center Retrospective Study"],"prefix":"10.1097","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-6025-4790","authenticated-orcid":false,"given":"Wei","family":"Yang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maoquan","family":"Qin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chenguang","family":"Jia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guanghua","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jie","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bin","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2026,2,25]]},"reference":[{"key":"R1-20260225","doi-asserted-by":"crossref","first-page":"11259","DOI":"10.3390\/ijms231911259","article-title":"Genomic landscape of mixed-phenotype acute leukemia","volume":"24","author":"Hennawi","year":"2022","journal-title":"Int J Mol Sci"},{"key":"R2-20260225","doi-asserted-by":"crossref","first-page":"2477","DOI":"10.1182\/blood-2014-10-551465","article-title":"How I treat mixed-phenotype acute leukemia","volume":"16","author":"Wolach","year":"2015","journal-title":"Blood"},{"key":"R3-20260225","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1002\/ajh.26758","article-title":"Integrative genomic and transcriptomic profiling reveals distinct molecular subsets in adult mixed phenotype acute leukemia","volume":"98","author":"Wang","year":"2023","journal-title":"Am J Hematol"},{"key":"R4-20260225","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1111\/ejh.13413","article-title":"Mixed phenotype acute leukemia: Biological profile, clinical characteristic and treatment outcomes: Report of the population-based study","volume":"105","author":"Zaj\u0105c-Spycha\u0142a","year":"2020","journal-title":"Eur J Haematol"},{"key":"R5-20260225","doi-asserted-by":"crossref","first-page":"3208","DOI":"10.1080\/10428194.2022.2118536","article-title":"Prognostic factors and outcomes of infant acute lymphoblastic leukemia (ALL), hypodiploid ALL, and mixed-phenotype acute leukemia (MPAL) in Canada: a report from CYP-C","volume":"63","author":"Tibout","year":"2022","journal-title":"Leuk Lymphoma"},{"key":"R6-20260225","doi-asserted-by":"crossref","first-page":"1974","DOI":"10.3390\/biomedicines10081974","article-title":"Mixed-phenotype acute leukemia: clinical diagnosis and therapeutic strategies","volume":"15","author":"George","year":"2022","journal-title":"Biomedicines"},{"key":"R7-20260225","first-page":"1783","article-title":"Proposals for the immunological classification of acute leukemias. European Group for the Immunological Characterization of Leukemias (EGIL)","volume":"9","author":"Bene","year":"1995","journal-title":"Leukemia"},{"key":"R8-20260225","doi-asserted-by":"crossref","first-page":"1703","DOI":"10.1038\/s41375-022-01613-1","article-title":"The 5th edition of the World Health Organization classification of haematolymphoid tumours: myeloid and histiocytic\/dendritic neoplasms","volume":"36","author":"Khoury","year":"2022","journal-title":"Leukemia"},{"key":"R9-20260225","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1182\/blood-2009-03-209262","article-title":"The 2008 revision of the World Health Organization (WHO) classification of myeloid neoplasms and acute leukemia: rationale and important changes","volume":"30","author":"Vardiman","year":"2009","journal-title":"Blood"},{"key":"R10-20260225","doi-asserted-by":"crossref","first-page":"2391","DOI":"10.1182\/blood-2016-03-643544","article-title":"The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia","volume":"127","author":"Arber","year":"2016","journal-title":"Blood"},{"key":"R11-20260225","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1002\/pbc.22105","article-title":"Stem cell transplant in the treatment of childhood biphenotypic acute leukemia","volume":"53","author":"Park","year":"2009","journal-title":"Pediatr Blood Cancer"},{"key":"R12-20260225","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1159\/000279442","article-title":"Nomenclature evolution: changes in the ISCN from the 2005 to the 2009 edition","volume":"127","author":"Brothman","year":"2009","journal-title":"Cytogenet Genome Res"},{"key":"R13-20260225","doi-asserted-by":"crossref","first-page":"106333","DOI":"10.1016\/j.leukres.2020.106333","article-title":"Prognosis of haploidentical hematopoietic stem cell transplantation in non-infant children with t(v;11q23)\/MLL-rearranged B-cell acute lymphoblastic leukemia","volume":"91","author":"Bai","year":"2020","journal-title":"Leuk Res"},{"key":"R14-20260225","doi-asserted-by":"crossref","first-page":"e147","DOI":"10.1016\/S2352-3026(23)00342-3","article-title":"Prophylaxis and management of graft-versus-host disease after stem-cell transplantation for haematological malignancies: updated consensus recommendations of the European Society for Blood and Marrow Transplantation","volume":"11","author":"Penack","year":"2024","journal-title":"Lancet Haematol"},{"key":"R15-20260225","first-page":"1","article-title":"Acute graft-versus-host disease: a brief review","volume":"20","author":"Alada\u011f","year":"2020","journal-title":"Turk J Haematol"},{"key":"R16-20260225","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1016\/j.bbmt.2014.12.001","article-title":"National Institutes of Health Consensus development project on criteria for clinical trials in chronic graft-versus-host disease: I. The 2014 Diagnosis and Staging Working Group Report","volume":"21","author":"Jagasia","year":"2015","journal-title":"Biol Blood Marrow Transplant"},{"key":"R17-20260225","first-page":"761","article-title":"Outcome of children with T cell acute lymphoblastic leukemia treated with Chinese Children Leukemia Group acute lymphoblastic leukemia (CCLG-ALL) 2008 protocol","volume":"57","author":"Liu","year":"2019","journal-title":"Zhonghua Er Ke Za Zhi"},{"key":"R18-20260225","first-page":"49","article-title":"Clinical effect and safety of CCLG-ALL 2008 (high risk group) protocol in the treatment of childhood mixed phenotype acute leukemia","volume":"29","author":"Zheng","year":"2021","journal-title":"Zhongguo Shi Yan Xue Ye Xue Za Zhi"},{"key":"R19-20260225","first-page":"373","article-title":"Clinical analysis of pediatric acute myeloid leukemia with CCLG-AML 2015 regimen","volume":"30","author":"Wang","year":"2022","journal-title":"Zhongguo Shi Yan Xue Ye Xue Za Zhi"},{"key":"R20-20260225","doi-asserted-by":"crossref","first-page":"e0268352","DOI":"10.1371\/journal.pone.0268352","article-title":"Combined inhibition of BCR-ABL1 and the proteasome as a potential novel therapeutic approach in BCR-ABL-positive acute lymphoblastic leukemia","volume":"17","author":"Maletzke","year":"2022","journal-title":"PLoS One"},{"key":"R21-20260225","doi-asserted-by":"crossref","first-page":"820191","DOI":"10.3389\/fphar.2021.820191","article-title":"Novel compounds synergize with Venetoclax to target KMT2A-rearranged pediatric acute myeloid leukemia","volume":"12","author":"Tregnago","year":"2022","journal-title":"Front Pharmacol"},{"key":"R22-20260225","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1002\/cncr.32552","article-title":"Children\u2019s Oncology Group Acute Leukemia of Ambiguous Lineage Task Force. Mixed-phenotype acute leukemia: a cohort and consensus research strategy from the Children\u2019s Oncology Group Acute Leukemia of Ambiguous Lineage Task Force","volume":"126","author":"Orgel","year":"2020","journal-title":"Cancer"},{"key":"R23-20260225","doi-asserted-by":"crossref","first-page":"1099","DOI":"10.1007\/s00277-023-05162-0","article-title":"Multicenter retrospective analysis of clinical outcome of adult patients with mixed-phenotype acute leukemia treated with acute myeloid leukemia-like or acute lymphoblastic leukemia-like chemotherapy and impact of allogeneic stem cell transplantation: a Campus ALL study","volume":"102","author":"Lazzarotto","year":"2023","journal-title":"Ann Hematol"},{"key":"R24-20260225","doi-asserted-by":"crossref","first-page":"1397","DOI":"10.1007\/s00277-024-05644-9","article-title":"Successful treatment of a B\/T MPAL patient by chemo-free treatment with venetoclax, azacitidine, and blinatumomab","volume":"103","author":"Liu","year":"2024","journal-title":"Ann Hematol"},{"key":"R25-20260225","doi-asserted-by":"crossref","first-page":"1","DOI":"10.21873\/cgp.20424","article-title":"Genetic characterization of pediatric mixed phenotype acute leukemia (MPAL)","volume":"21","author":"Panagopoulos","year":"2024","journal-title":"Cancer Genomics Proteomics"},{"key":"R26-20260225","doi-asserted-by":"crossref","first-page":"107665","DOI":"10.1016\/j.leukres.2025.107665","article-title":"Molecular genetic characterization of mixed-phenotype acute leukemia (MPAL) with BCR::ABL1 fusion","volume":"151","author":"Shi","year":"2025","journal-title":"Leuk Res"},{"key":"R27-20260225","doi-asserted-by":"crossref","first-page":"3163","DOI":"10.1182\/blood-2010-10-314682","article-title":"Mixed-phenotype acute leukemia: clinical and laboratory features and outcome in 100 patients defined according to the WHO 2008 classification","volume":"117","author":"Matutes","year":"2011","journal-title":"Blood"},{"key":"R28-20260225","doi-asserted-by":"crossref","first-page":"919","DOI":"10.3324\/haematol.2008.003202","article-title":"Clinical and biological characteristics of adult biphenotypic acute leukemia in comparison with that of acute myeloid leukemia and acute lymphoblastic leukemia: a case series of a Chinese population","volume":"94","author":"Xu","year":"2009","journal-title":"Haematologica"},{"key":"R29-20260225","doi-asserted-by":"crossref","first-page":"1015","DOI":"10.1002\/ajh.25873","article-title":"Prognostic impact of Philadelphia chromosome in mixed phenotype acute leukemia (MPAL): a cancer registry analysis on real-world outcome","volume":"95","author":"Qasrawi","year":"2020","journal-title":"Am J Hematol"},{"key":"R30-20260225","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1007\/s12185-011-0953-1","article-title":"Clinical characteristics and outcomes of mixed phenotype acute leukemia with Philadelphia chromosome positive and\/or bcr-abl positive in adult","volume":"94","author":"Wang","year":"2011","journal-title":"Int J Hematol"},{"key":"R31-20260225","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1111\/ejh.12343","article-title":"Philadelphia chromosome-positive mixed phenotype acute leukemia in the imatinib era","volume":"93","author":"Shimizu","year":"2014","journal-title":"Eur J Haematol"},{"key":"R32-20260225","doi-asserted-by":"crossref","first-page":"8741","DOI":"10.1002\/cam4.4413","article-title":"Comparison of allogeneic hematopoietic stem cell transplantation and TKI combined with chemotherapy for adult Philadelphia chromosome positive acute lymphoblastic leukemia: a systematic review and meta-analysis","volume":"10","author":"Zeng","year":"2021","journal-title":"Cancer Med"},{"key":"R33-20260225","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1002\/ccr3.763","article-title":"Mixed phenotype acute leukemia with t (9;22): success with nonacute myeloid leukemia-type intensive induction therapy and stem cell transplantation","volume":"5","author":"Chan","year":"2017","journal-title":"Clin Case Rep"},{"key":"R34-20260225","doi-asserted-by":"crossref","first-page":"1623528","DOI":"10.3389\/fonc.2025.1623528","article-title":"Philadelphia chromosome-positive mixed-phenotype acute leukemia: a case report and literature review","volume":"15","author":"Yang","year":"2025","journal-title":"Front Oncol"},{"key":"R35-20260225","doi-asserted-by":"crossref","first-page":"481.e1","DOI":"10.1016\/j.jtct.2021.02.032","article-title":"Early T-cell precursor acute lymphoblastic leukemia and T\/myeloid mixed phenotype acute leukemia possess overlapping characteristics and both benefit from CAG-like regimens and allogeneic hematopoietic stem cell transplantation","volume":"27","author":"Liu","year":"2021","journal-title":"Transplant Cell Ther"},{"issue":"suppl 2","key":"R36-20260225","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1038\/s41409-019-0605-2","article-title":"Update of the \u201cBeijing Protocol\u201d haplo-identical hematopoietic stem cell transplantation","volume":"54","author":"Lv","year":"2019","journal-title":"Bone Marrow Transplant"},{"key":"R37-20260225","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1111\/famp.12772","article-title":"Chinese childbearing decision-making in mainland China in the post-one-child-policy era","volume":"62","author":"Su-Russell","year":"2023","journal-title":"Fam Process"},{"key":"R38-20260225","doi-asserted-by":"crossref","first-page":"794541","DOI":"10.3389\/fped.2021.794541","article-title":"T-cell-replete versus ex vivo T-cell-depleted haploidentical haematopoietic stem cell transplantation in children with acute lymphoblastic leukaemia and other haematological malignancies","volume":"9","author":"Kleinschmidt","year":"2021","journal-title":"Front Pediatr"},{"key":"R39-20260225","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1038\/sj.bmt.1705445","article-title":"Haploidentical hematopoietic stem cell transplantation without in vitro T-cell depletion for the treatment of hematological malignancies","volume":"38","author":"Huang","year":"2006","journal-title":"Bone Marrow Transplant"},{"key":"R40-20260225","doi-asserted-by":"crossref","first-page":"1611","DOI":"10.1016\/j.bbmt.2018.12.007","article-title":"Allogeneic hematopoietic stem cell transplantation, especially haploidentical, may improve long-term survival for high-risk pediatric patients with Philadelphia chromosome-positive acute lymphoblastic leukemia in the tyrosine kinase inhibitor era","volume":"25","author":"Xue","year":"2019","journal-title":"Biol Blood Marrow Transplant"},{"key":"R41-20260225","doi-asserted-by":"crossref","first-page":"424.e1","DOI":"10.1016\/j.jtct.2021.01.016","article-title":"Outcomes of unmanipulated haploidentical transplantation using post-transplant cyclophosphamide (PT-Cy) in pediatric patients with acute lymphoblastic leukemia","volume":"27","author":"Ruggeri","year":"2021","journal-title":"Transplant Cell Ther"},{"key":"R42-20260225","doi-asserted-by":"crossref","first-page":"1898","DOI":"10.1016\/j.bbmt.2019.05.036","article-title":"Incidence, risk factors, and outcomes of primary poor graft function after allogeneic hematopoietic stem cell transplantation","volume":"25","author":"Zhao","year":"2019","journal-title":"Biol Blood Marrow Transplant"},{"key":"R43-20260225","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1080\/17474086.2021.1923475","article-title":"Optimizing outcomes for haploidentical hematopoietic stem cell transplantation in severe aplastic anemia with intensive GVHD prophylaxis: a review of current findings","volume":"14","author":"Xu","year":"2021","journal-title":"Expert Rev Hematol"},{"key":"R44-20260225","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1016\/j.bbmt.2008.11.025","article-title":"Treatment of acute leukemia with unmanipulated HLA-mismatched\/haploidentical blood and bone marrow transplantation","volume":"15","author":"Huang","year":"2009","journal-title":"Biol Blood Marrow Transplant"},{"key":"R45-20260225","first-page":"715","article-title":"A direct comparison of immunological characteristics of granulocyte colony-stimulating factor (G-CSF)-primed bone marrow grafts and G-CSF-mobilized peripheral blood grafts","volume":"90","author":"Jun","year":"2005","journal-title":"Haematologica"}],"container-title":["Journal of Pediatric Hematology\/Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/MPH.0000000000003166","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T15:00:35Z","timestamp":1772031635000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/MPH.0000000000003166"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,25]]},"references-count":45,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.1097\/mph.0000000000003166","relation":{},"ISSN":["1077-4114","1536-3678"],"issn-type":[{"value":"1077-4114","type":"print"},{"value":"1536-3678","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,25]]},"assertion":[{"value":"2024-12-25","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-22","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}