Leukemias
Mixed-phenotype acute leukemia, B/myeloid
B/myeloid mixed-phenotype acute leukemia (MPAL) is an acute leukemia with defining features of both B-lymphoid and myeloid lineages. Expert review of cell markers and genetics is needed because this is different from ordinary B-ALL or AML with an occasional extra marker.
Other names and abbreviations
MPAL B/myeloid · biphenotypic acute leukemia · B/myeloid biphenotypic or bilineal acute leukaemia (older terms)
Where transplant fits
Allogeneic transplantation is often considered for eligible adults and selected high-risk or poorly responding patients. Some children with a good response can be treated without transplant. A donor may be related, unrelated or an appropriate alternative; the diagnosis does not establish one universal transplant sequence.
Treatment depends on the exact diagnosis, disease stage, prior treatment and the person’s health. These categories are not estimates of donor demand.
Treatment at a glance
- Who it affects
- B/myeloid MPAL can occur in children and adults.
- Other treatment options
- Treatment often begins with an ALL-based approach, with targeted medicines when a relevant alteration is present. Response and measurable residual disease help guide later treatment. Pediatric and adult strategies differ, and clinical trials are important.
- Cells used for transplantation
- Donated blood-forming cells for allogeneic transplantation. Marrow, peripheral blood or cord blood and donor type are selected for the patient and transplant approach.
Questions to bring to your care team
What is the exact diagnosis or subtype? What is the goal of each treatment option? If transplant is being considered, why does it fit this situation, which cells would be used and what are the alternatives?
Sources and further reading
- WHO fifth-edition classification: Myeloid and Histiocytic/Dendritic Neoplasms
WHO classification authors / Leukemia · Accessed 2026-09-05 - WHO fifth-edition classification: Lymphoid Neoplasms
WHO classification authors / Leukemia · Accessed 2026-09-05 - Acute Lymphoblastic Leukemia Treatment (PDQ), Health Professional Version
NCI · Accessed 2026-09-05 - Childhood Acute Lymphoblastic Leukemia Treatment (PDQ), Health Professional Version
NCI · Accessed 2026-09-05 - Indications for haematopoietic cell transplantation and CAR-T: 2025 EBMT practice recommendations
EBMT / Bone Marrow Transplantation · Accessed 2026-09-05 - Stem Cell and Bone Marrow Transplants for Cancer
NCI · Accessed 2026-09-05 - Donor and cord blood unit selection guidelines
NMDP / CIBMTR · Accessed 2026-09-05
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