Induction Protocol For Acute Mixed Phenotypic Leukemia: A META Analysis

BACKGROUND:MPAL encompasses a heterogeneous group of leukemia with a poor prognosis,and there is not any consensus on the optimal treatment of patients with MPAL.We perform a meta analysis to find out which type of induction regimen is optimal for MPAL.METHODS:Case series meta-analysis was conducted with English language restriction,(from 1995 January to 2016 May):including studies from:Cochrane Central,Medline and EMBASE.Proportional meta-analysis was performed on descriptive data and outcomes of treatment with a random-effects model and the 95%confidential intervals were calculated.RESULTS:A total of 14 case series studies with a total of 366 MPAL patients were included in the meta-analysis.The CR rate of ALL type regimens was the highest.ALL type regimens resulted in statistically significant higher CR rate than AML type regimens:74.3%(95%CI 66.1%-82.5%)vs 46.4%(95%CI 37.7%-55.1%),respectively.However,there was no statistical difference in CR rate between ALL type regimens and combined regimens:74.3%(95%CI 66.1%-82.5%)vs 68.2%(95%CI 59.0%-79.5%),respectively.The CR rate of ALL regimens,AML regimens,and combined regimens in patients with Ph+ was 44.3%(95%CI 12.0%to 76.6%),64.3%(95%CI 32.2%to 96.4%)and 24.2%(95%CI 2.0%-40.4%),respectively,and no statistical difference was there.The CR rate of imatinib combination group(n=37)and chemotherapy group(n=39)in patients with Ph+was 81.0%(95%CI 58.2%to 92.1%)and 54.6%(95%CI 31.1%-76.2%),respectively,and there was no statistical difference.The CR rate of ALL regimens,combined regimens,and AML regimens in patients with MPO positive was 43.5%(95%Cl 37.7%-48.7%),38.9%(95%CI 16.0%-52.0%)and 57.9%(95%CI 42.5%to 73.4%),respectively,and no statistical difference was there.CONCLUSION:Our analysis found that the CR rate wasstatistically significant higher in ALL-type regimens group than that in AML regimens group.