Acute leukemia of ambiguous lineage(ALAL)is a rare type of acute leukemia and is extremely difficult to treat.Here,we present six patients with CD 19-positive ALAL who were successfully treated with blinatumomab-based combination treatment in the front-line setting.Five were diagnosed with B-cell/myeloid mixed phenotype acute leukemia(MPAL)and one with B-cell/T cell MPAL.All six patients achieved complete remission after one cycle of blinatumomab combination treatment.Furthermore,3(50％)patients achieved MRD-negative(＜0.01％)by flow cytometry and 2(50％)of four patients with evaluable molecular MRD achieved molecular remission.At some point during the treatment,5(83.3％)patients achieved MRD negativity and all four patients with evaluable molecular MRD had molecular remission.The overall survival was 100％,and the event-free survival was 83.3％after a median follow-up time of 15 months.This study provides preliminary evidence that blinatumomab-based combination therapy is an effective and safe treatment for patients with CD 19-positive ALAL in the front-line setting.
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