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The document discusses the importance of antiviral prophylaxis to prevent herpes simplex virus (HSV) and varicella zoster virus (VZV) reactivation in adult patients with newly diagnosed acute leukemia. It highlights the efficacy of antiviral medications like acyclovir in reducing the incidence of symptomatic HSV reactivation during intensive chemotherapy. The study conducted in Italian centers belonging to SEIFEM group revealed a heterogeneous scenario in antiviral prophylaxis policies, with some centers not adhering to current international guidelines. The authors suggest the need for harmonization in applying antiviral prevention approaches and further prospective studies to optimize the schedule and duration of antiviral prophylaxis in different acute leukemia subgroups. [Extracted from the article]

Mixed-phenotype acute leukemia (MPAL) is a rare disease. Treatment is often similar to that of acute lymphoblastic leukemia (ALL), but the outcome in adults and the role of allogeneic stem cell transplantation (AlloSCT) are not well defined. We report on 77 adult patients diagnosed with MPAL over the last 10 years and treated with a curative intent. Median age was 49 years; 7.6% of cases had a BCR::ABL1 rearrangement. Thirty patients (39%) were treated with an acute myeloid leukemia (AML)–like induction and 47 (61%) with an ALL-like scheme. The complete remission (CR) rate was 67.6% and an ALL-like therapy was associated with a better CR rate (P = 0.048). The median OS was 41.9 months; age ≤ 60 years was associated with a better OS (67 vs 26 months, P = 0.014). An AlloSCT was performed in 50 patients (65%). The 5-year OS of transplanted patients was 54%. The OS post-AlloSCT was better in patients who were minimal residual disease (MRD)-negative prior to transplant (75.8% vs 45.2%, P = 0.06). This study shows that MPAL patients respond better to an ALL-like induction therapy; that consolidation therapy should include, whenever possible, an AlloSCT and that MRD negativity should be a primary endpoint of treatment. [ABSTRACT FROM AUTHOR]