Acute leukemia of ambiguous lineage

Summary

Acute leukemia of ambiguous lineage (MONDO:0019460) is a cancer and 34 clinical trials. Top therapeutic interventions include revumenib, calaspargase pegol, and dexrazoxane. A subtype of acute myeloid leukemia — broader associated-gene and molecular evidence is on the parent page (see Disease family below).

At a glance

• Classification: Cancer
• ClinVar variants: 1
• Clinical trials: 34

Clinical features

No curated clinical features (Orphanet) for this disease.

Identifiers

Disease identifiers

Field	Value
Canonical name	acute leukemia of ambiguous lineage
Mondo ID	MONDO:0019460
Orphanet	86851
ICD-11	1062906118
NCIT	C7464
SNOMED CT	721308005
UMLS	C1301357
MedGen	226983
GARD	0008638
MedDRA	10067399
Is cancer (heuristic)	yes

Also known as: acute leukaemia of indeterminate lineage · acute leukaemia of undetermined lineage · acute leukemia of ambiguous lineage · acute leukemia of indeterminate lineage · acute leukemia of undetermined lineage · ALL with myeloid markers · AML with lymphoid markers · BAL · biphenotypic acute leukaemia · biphenotypic acute leukemia · hybrid acute leukaemia · hybrid acute leukemia · mixed lineage acute leukaemia · mixed lineage acute leukemia · mixed phenotype acute leukaemia

Data availability: 1 ClinVar variant · 1 cell line.

Disease family

This is a subtype of acute myeloid leukemia. Genetic, therapeutic, and trial evidence is largely curated at the broader-term level — see the parent page for the associated-gene cohort and molecular evidence.

Classification path: human disease › disease by etiologic mechanism › cancer or benign tumor › neoplastic disease or syndrome › neoplasm › hematopoietic and lymphoid system neoplasm › hematopoietic and lymphoid cell neoplasm › leukemia › myeloid leukemia › acute myeloid leukemia › acute leukemia of ambiguous lineage

Related subtypes (77): childhood acute myeloid leukemia, acute monocytic leukemia, acute myeloid leukemia with t(8;21)(q22;q22) translocation, acute myeloid leukemia by FAB classification, inherited acute myeloid leukemia, acute myeloid leukemia with CEBPA somatic mutations, acute myeloid leukemia with t(8;16)(p11;p13) translocation, acute myeloid leukemia with t(6;9)(p23;q34), acute myeloid leukemia with t(9;11)(p22;q23), acute myeloid leukemia with inv3(p21;q26.2) or t(3;3)(p21;q26.2), megakaryoblastic acute myeloid leukemia with t(1;22)(p13;q13), acute myeloid leukemia with NPM1 somatic mutations, acute myeloid leukemia with multilineage dysplasia, therapy related acute myeloid leukemia and myelodysplastic syndrome, acute myeloid leukemia with abnormal bone marrow eosinophils inv(16)(p13q22) or t(16;16)(p13;q22), acute myeloid leukemia with 11q23 abnormalities, acute myeloid leukemia with BCR-ABL1, acute myeloid leukemia with mutated NPM1, acute myeloid leukemia, inv(16)(p13.1;q22), acute myeloid leukemia, t(16;16)(p13.1;q22), acute myeloid leukemia, t(15;17)(q24;q21), acute myeloid leukemia, t(9;11)(p21.3;q23.3), acute myeloid leukemia, t(10;11)(p12;q23), acute myeloid leukemia, t(10;11)(p11.2;q23), acute myeloid leukemia, t(1;11)(q21;q23), acute myeloid leukemia, t(4;11)(q21;q23), acute myeloid leukemia, t(6;11)(q27;q23), acute myeloid leukemia, t(6;9)(p23;q34.1), acute myeloid leukemia, t(11;19)(q23;p13), acute myeloid leukemia, t(11;19)(q23;p13.1), acute myeloid leukemia, t(11;19)(q23.3;p13.3), acute myeloid leukemia, t(v;11q23.3), acute myeloid leukemia, Monosomy 7, acute myeloid leukemia, Monosomy 5, acute myeloid leukemia, Trisomy 8, acute myeloid leukemia, der12p, acute myeloid leukemia, t(2;12), acute myeloid leukemia, t(11;17), acute myeloid leukemia, t(8;16), acute myeloid leukemia, t(1;22), acute myeloid leukemia, t(5;11)(q35;p15), acute myeloid leukemia, t(7;12)(q36;p13), acute myeloid leukemia, t(9;22)(q34.1;q11.2), acute myeloid leukemia, inv(3)(q21.3;q26.2), acute myeloid leukemia, t(3;3)(q21.3;q26.2), acute myeloid leukemia, t(3;12)(q23;p12.3), acute myeloid leukemia, del(5q31-q32), acute myeloid leukemia, del(13q14-q21), acute myeloid leukemia, loss of chromosome 17p, acute myeloid leukemia, MLL gene rearrangement, acute myeloid leukemia, Non-KMT2A MLLT10 rearrangement positive, acute myeloid leukemia, inv(16)(p13.3;q24.3), acute myeloid leukemia, t(11;15)(p15;q35), acute myeloid leukemia, t(16;21)(q24;q22), acute myeloid leukemia, t(3;5)(q25;q34), acute myeloid leukemia, t(16;21)(p11;q22), acute myeloid leukemia, monoallelic CEBPA gene mutation, acute myeloid leukemia, biallelic CEBPA gene mutation, acute myeloid leukemia, CEBPA gene mutation, acute myeloid leukemia, FLT3 internal tandem duplication, acute myeloid leukemia, FLT3 tyrosine kinase domain point mutation, acute myeloid leukemia, WT1 gene mutation, acute myeloid leukemia, KIT exon 17 mutation, acute myeloid leukemia, KIT exon 8 mutation, acute myeloid leukemia, KIT gene mutation, acute myeloid leukemia, GATA1 gene mutation, acute myeloid leukemia, RUNX1 gene mutation, acute myeloid leukemia, PTPN11 gene mutation, acute myeloid leukemia, NRAS gene mutation, acute myeloid leukemia, KRAS gene mutation, core binding factor acute myeloid leukemia, acute myeloid leukemia, t(8;21)(q22; q22.1), acute myeloid leukemia, t(1;22)(p13;q13), acute myeloid leukemia with CBFA2T3-GLIS2 fusion, acute myeloid leukemia with FUS-ERG fusion, acute myeloid leukemia with MNX1-ETV6 fusion, acute myeloid leukemia with NPM1-MLF1 fusion

Subtypes (3): bilineal acute myeloid leukemia, acute undifferentiated leukemia, mixed phenotype acute leukemia

Genetics & variants

GWAS landscape

No GWAS associations recorded — common-variant (GWAS) studies don’t cover this disease (typical for Mendelian / rare diseases). See the curated gene cohort and Mendelian overlap below.

Variant details and genetic-evidence tiers

ClinVar germline variants

1 retrieved; paginated sample, class counts are floors:

1 conflicting classifications of pathogenicity

ClinVar	Variant (HGVS)	Gene	Classification	Review
2232	NM_000551.4(VHL):c.598C>T (p.Arg200Trp)	LOC107303340	Conflicting classifications of pathogenicity	criteria provided, conflicting classifications

Genes & proteins

No associated-gene cohort resolved for this disease. Atlas builds the molecular and therapeutic sections — associated genes, protein families, druggability, pathways, interactions, and drug associations — by aggregating over a disease’s associated genes (resolved via GWAS / GenCC / ClinVar / CIViC), and none resolved here. This is expected for antibody-mediated, autoimmune, or otherwise non-gene-defined conditions; the curated evidence for this disease is its clinical features, GWAS susceptibility, and clinical trials (above).

Function

No pathway enrichment — requires an associated-gene cohort.

Therapeutics

No druggable-target or therapeutic data for this disease’s cohort.

Clinical trials & evidence

Clinical trials

Clinical trials: 34.

Phase distribution (across all retrieved trials)

Phase	Trials
PHASE2	20
PHASE1	6
Not specified	3
PHASE2/PHASE3	2
PHASE1/PHASE2	2
PHASE3	1

Top trials by phase / activity

NCT	Phase	Status	Title
NCT05515029	PHASE3	ACTIVE_NOT_RECRUITING	Preventing of GVHD With Post-transplantation Cyclophosphamide, Abatacept, Vedolizumab and Calcineurin Inhibitor at Patients With Hemoblastosis
NCT06475820	PHASE2/PHASE3	ACTIVE_NOT_RECRUITING	Preventing of GVHD With Post-transplantation Cyclophosphamide, Abatacept, Vedolizumab and Baricitinib at Children and Young Adults With Hemoblastosis
NCT06756152	PHASE2/PHASE3	RECRUITING	Preventing of GVHD with Post-transplantation Cyclophosphamide, Abatacept, Vedolizumab and Ruxolitinib At Children and Young Adults with Hemoblastosis
NCT03779854	PHASE2	RECRUITING	Naive T Cell Depletion for Preventing Chronic Graft-versus-Host Disease in Children and Young Adults With Blood Cancers Undergoing Donor Stem Cell Transplant
NCT04065399	PHASE1/PHASE2	RECRUITING	A Study of Revumenib in R/R Leukemias Including Those With an MLL/KMT2A Gene Rearrangement or NPM1 Mutation
NCT04067336	PHASE1/PHASE2	ACTIVE_NOT_RECRUITING	First in Human Study of Ziftomenib in Relapsed or Refractory Acute Myeloid Leukemia
NCT04440267	PHASE2	RECRUITING	Efficacy of Acute Lymphoblastic Leukemia-Based Therapy in Treating Patients With Acute Leukemia of Ambiguous Lineage
NCT05761171	PHASE2	ACTIVE_NOT_RECRUITING	A Study of Revumenib in Combination With Chemotherapy for Patients Diagnosed With Relapsed or Refractory Leukemia
NCT05805605	PHASE2	RECRUITING	Allo HSCT Using RIC and PTCy for Hematological Diseases
NCT05901974	PHASE2	RECRUITING	Venetoclax Combined With Azactidine in the Treatment of ALAL
NCT06013423	PHASE2	RECRUITING	Cord Blood Transplant, Cyclophosphamide, Fludarabine, and Total-Body Irradiation in Treating Patients With High-Risk Hematologic Diseases
NCT06317662	PHASE2	RECRUITING	Testing the Addition of the Anti-cancer Drug Venetoclax and/or the Anti-cancer Immunotherapy Blinatumomab to the Usual Chemotherapy Treatment for Infants With Newly Diagnosed KMT2A-rearranged or KMT2A-non-rearranged Leukemia
NCT06355583	PHASE2	RECRUITING	Intestinal Microbiota Transplant Prior to Allogeneic Stem Cell Transplant (MAST) Trial
NCT06477549	PHASE2	RECRUITING	BeFluBu vs FluBuRux Conditioning in Haploidentical HCT
NCT06508099	PHASE2	RECRUITING	Vitamin A and D Supplementation in Allogeneic HCT
NCT07046078	PHASE2	RECRUITING	Combination Chemotherapy (FLAG-Ida) Followed Immediately by Reduced-Intensity Total Body Radiation Therapy and Donor Hematopoietic Cell Transplant for the Treatment of Adults Age 60 and Older With Newly Diagnosed Adverse-Risk Acute Myeloid Leukemia or Other High-Grade Myeloid Cancer
NCT00863148	PHASE2	COMPLETED	Allogeneic Stem Cell Transplant With Clofarabine, Busulfan and Antithymocyte Globulin (ATG) for Adult Patients With High-risk Acute Myeloid Leukemia/Myelodysplastic Syndromes (AML/MDS) or Acute Lymphoblastic Leukemia (ALL)
NCT01858740	PHASE2	COMPLETED	Selective Depletion of CD45RA+ T Cells From Allogeneic Peripheral Blood Stem Cell Grafts in Preventing GVHD in Children
NCT02135874	PHASE2	COMPLETED	Clofarabine, Idarubicin, Cytarabine, Vincristine Sulfate, and Dexamethasone in Treating Patients With Newly Diagnosed or Relapsed Mixed Phenotype Acute Leukemia
NCT02220985	PHASE2	COMPLETED	Selective Depletion of CD45RA+ T Cells From Allogeneic Peripheral Blood Stem Cell Grafts From HLA-Matched Related and Unrelated Donors in Preventing GVHD
NCT02419755	PHASE2	TERMINATED	Bortezomib and Vorinostat in Younger Patients With Refractory or Relapsed MLL Rearranged Hematologic Malignancies
NCT02828358	PHASE2	COMPLETED	Azacitidine and Combination Chemotherapy in Treating Infants With Acute Lymphoblastic Leukemia and KMT2A Gene Rearrangement
NCT03012672	PHASE2	COMPLETED	Higher or Lower Dose Cladribine, Cytarabine, and Mitoxantrone in Treating Medically Less Fit Patients With Newly Diagnosed Acute Myeloid Leukemia or Myeloid Neoplasm
NCT04191187	PHASE2	COMPLETED	Reduced Intensity Flu/Mel/TBI Conditioning for HAPLO HCT Patients With Hematologic Malignancies
NCT04942730	PHASE2	COMPLETED	Benadamustine, Fludarabine and Busulfan Conditioning in Recipients of Haploidentical Stem Cell Transplantation (FluBuBe)
NCT05292664	PHASE1	RECRUITING	Venetoclax Basket Trial for High Risk Hematologic Malignancies
NCT06177067	PHASE1	RECRUITING	Study of Revumenib, Azacitidine, and Venetoclax in Pediatric and Young Adult Patients With Refractory or Relapsed Acute Myeloid Leukemia
NCT06575296	PHASE1	RECRUITING	Revumenib for the Treatment of Acute Leukemia in Patients Post-Allogeneic Stem Cell Transplant
NCT01319864	PHASE1	COMPLETED	POETIC Plerixafor as a Chemosensitizing Agent for Relapsed Acute Leukemia and MDS in Pediatric Patients
NCT01701323	PHASE1	TERMINATED	Expanded Cord Blood Cell Infusion Following Combination Chemotherapy in Younger Patients With Relapsed or Refractory Acute Myeloid Leukemia
NCT05521087	PHASE1	WITHDRAWN	A Study of JNJ-75276617 in Combination With Conventional Chemotherapy for Pediatric and Young Adult Participants With Relapsed/Refractory Acute Leukemias
NCT05794880	Not specified	RECRUITING	MCW Alpha/Beta T-Cell and B-Cell Depletion With Targeted ATG Dosing
NCT07094750	Not specified	NOT_YET_RECRUITING	Randomization for the Identification of Best Treatment Intensity for Less Fit Adults With Acute Myeloid Leukemia and Myeloid Neoplasms
NCT02551718	Not specified	COMPLETED	High Throughput Drug Sensitivity Assay and Genomics- Guided Treatment of Patients With Relapsed or Refractory Acute Leukemia

Drugs tested across these trials (top 30)

Molecule	Max phase	Trials referencing
REVUMENIB	4	4
CALASPARGASE PEGOL	4	3
DEXRAZOXANE	4	3
ASPARAGINASE	4	2
BENDAMUSTINE HYDROCHLORIDE	4	2
DAUNORUBICIN	4	2
HYDROCORTISONE SODIUM SUCCINATE	4	2
MITOXANTRONE	4	2
THIOGUANINE	4	2
ABATACEPT	4	1
ASPARAGINASE ERWINIA CHRYSANTHEMI	4	1
BARICITINIB	4	1
BLINATUMOMAB	4	1
CLADRIBINE	4	1
CLOFARABINE	4	1
COBICISTAT	4	1
ITRACONAZOLE	4	1
LEVOLEUCOVORIN	4	1
PEGASPARGASE	4	1
RETINOL	4	1
SORAFENIB	4	1
VEDOLIZUMAB	4	1
ZIFTOMENIB	1	1
CHEMBL5427854	0	1
CHEMBL4776881	0	1
HYOSCYAMINE	-1	1