Overview
Mixed phenotype acute leukemia (MPAL) is a rare and aggressive type of blood cancer. It is sometimes called mixed lineage leukemia, biphenotypic acute leukemia, or bilineal acute leukemia. In most leukemias, the cancer cells clearly look like either a B-cell, T-cell, or myeloid cell — the main types of blood cells. In MPAL, the leukemia cells have features of more than one blood cell type at the same time, or there are two separate groups of cancer cells each belonging to a different type. This makes MPAL harder to classify and treat than more common leukemias. MPAL affects the bone marrow, which is the spongy tissue inside bones where blood cells are made. When leukemia cells crowd the bone marrow, the body cannot make enough healthy red blood cells, white blood cells, or platelets. This leads to symptoms like extreme tiredness, frequent infections, easy bruising, and bleeding. The disease can affect both children and adults, though it is more common in adults. Treatment usually involves intensive chemotherapy, often combining approaches used for both acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). Many patients go on to receive a stem cell transplant if they respond well to initial treatment. Because MPAL is so rare, treatment decisions are complex and are best made at specialized cancer centers with experience in rare leukemias.
Also known as:
Key symptoms:
Extreme tiredness and weaknessPale skinFrequent or severe infectionsFever that does not go awayEasy bruisingUnusual or prolonged bleeding (such as from the gums or nose)Tiny red or purple spots on the skin (called petechiae)Swollen lymph nodes in the neck, armpits, or groinBone or joint painSwollen spleen or liver causing belly discomfortShortness of breathUnexplained weight lossNight sweats
Sporadic
Usually appears on its own, not inherited from a parent
Variable
Can begin at different ages, from infancy through adulthood
FDA & Trial Timeline
2 eventsInstitute of Hematology & Blood Diseases Hospital, China — NA
West Virginia University — PHASE2
Data sourced from FDA regulatory filings and ClinicalTrials.gov. Updated periodically.
Treatments
No FDA-approved treatments are currently listed for Mixed phenotype acute leukemia.
1 clinical trialare actively recruiting — trials can provide access to cutting-edge therapies.
View clinical trials →Treatment Centers
8 centersBaylor College of Medicine Rare Disease Center ↗
Baylor College of Medicine
📍 Houston, TX
🏥 NORDStanford Medicine Rare Disease Center ↗
Stanford Medicine
📍 Stanford, CA
🔬 UDNNIH Clinical Center Undiagnosed Diseases Program ↗
National Institutes of Health
📍 Bethesda, MD
🔬 UDNUCLA UDN Clinical Site ↗
UCLA Health
📍 Los Angeles, CA
🔬 UDNBaylor College of Medicine UDN Clinical Site ↗
Baylor College of Medicine
📍 Houston, TX
🔬 UDNHarvard/MGH UDN Clinical Site ↗
Massachusetts General Hospital
📍 Boston, MA
🏥 NORDMayo Clinic Center for Individualized Medicine ↗
Mayo Clinic
📍 Rochester, MN
👤 Mayo Clinic Center for Individualized Medicine
🏥 NORDUCLA Rare Disease Day Program ↗
UCLA Health
📍 Los Angeles, CA
Travel Grants
No travel grants are currently matched to Mixed phenotype acute leukemia.
Community
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Caregiver Resources
NORD Caregiver Resources
Support, advocacy, and financial assistance for caregivers of rare disease patients.
Mental Health Support
Rare disease caregiving can be isolating. Connect with counseling and peer support.
Family & Caregiver Grants
Financial assistance programs specifically for caregivers of rare disease patients.
Social Security Disability
Learn how rare disease patients may qualify for SSDI/SSI benefits.
Questions for your doctor
Bring these to your next appointment
- Q1.What specific subtype of MPAL do I have, and what genetic features were found in my leukemia cells?,Which chemotherapy regimen do you recommend for me, and why — is it ALL-based, AML-based, or a combination?,Am I a candidate for a stem cell transplant, and when would that happen?,Are there any clinical trials available for my type of MPAL that I should consider?,What are the signs of infection I should watch for at home, and when should I go to the emergency room?,What is the plan if my leukemia does not respond to the first treatment or comes back?,What support services — such as social work, mental health counseling, or fertility preservation — are available to me?
Common questions about Mixed phenotype acute leukemia
What is Mixed phenotype acute leukemia?
Mixed phenotype acute leukemia (MPAL) is a rare and aggressive type of blood cancer. It is sometimes called mixed lineage leukemia, biphenotypic acute leukemia, or bilineal acute leukemia. In most leukemias, the cancer cells clearly look like either a B-cell, T-cell, or myeloid cell — the main types of blood cells. In MPAL, the leukemia cells have features of more than one blood cell type at the same time, or there are two separate groups of cancer cells each belonging to a different type. This makes MPAL harder to classify and treat than more common leukemias. MPAL affects the bone marrow, w
How is Mixed phenotype acute leukemia inherited?
Mixed phenotype acute leukemia follows a sporadic inheritance pattern. Genetic counseling can help families understand recurrence risk and testing options.
Are there clinical trials for Mixed phenotype acute leukemia?
Yes — 1 recruiting clinical trial is currently listed for Mixed phenotype acute leukemia on UniteRare. See the clinical trials section on this page for phase, sponsor, and site details sourced from ClinicalTrials.gov.
Which specialists treat Mixed phenotype acute leukemia?
25 specialists and care centers treating Mixed phenotype acute leukemia are listed on UniteRare, sourced from ClinicalTrials.gov principal investigators, published research, and the NPPES NPI registry.