Vol 9, No 2 (2018)
Case report
Published online: 2018-08-17

open access

Page views 685
Article views/downloads 2717
Get Citation

Connect on Social Media

Connect on Social Media

Acute leukemia with coexpression of lymph and myeloid antigens and massive lymphadenopathy as a diagnostic and therapeutic problem.

Marcin Fejklowicz1, Sebastian Grosicki2
Hematologia 2018;9(2):146-152.

Abstract

The paper describes the case of a 20-year-old patient with acute leukemia of undetermined linear origin accompanied by massive lymphadenopathy. The patient was treated with acute lymphoblastic leukemia regimen, according to the PALG ALL6 protocol, achieving complete hematological and metabolic remission of the underlying disease.

Article available in PDF format

View PDF (Polish) Download PDF file

References

  1. Wolach O, Stone RM. How I treat mixed-phenotype acute leukemia. Blood. 2015; 125(16): 2477–2485.
  2. Greaves MF, Chan LC, Furley AJ, et al. Lineage promiscuity in hemopoietic differentiation and leukemia. Blood. 1986; 67(1): 1–11.
  3. Smith LJ, Curtis JE, Messner HA, et al. Lineage infidelity in acute leukemia. Blood. 1983; 61(6): 1138–1145.
  4. Nishiuchi T, Ohnishi H, Kamada R, et al. Acute leukemia of ambiguous lineage, biphenotype, without CD34, TdT or TCR-rearrangement. Intern Med. 2009; 48(16): 1437–1441.
  5. Deshpande AJ, Buske C. Lymphoid progenitors as candidate cancer stem cells in AML: new perspectives. Cell Cycle. 2007; 6(5): 543–545.
  6. Yan M, Kanbe E, Peterson LF, et al. A previously unidentified alternatively spliced isoform of t(8;21) transcript promotes leukemogenesis. Nat Med. 2006; 12(8): 945–949.
  7. Béné MC. Biphenotypic, bilineal, ambiguous or mixed lineage: strange leukemias! Haematologica. 2009; 94(7): 891–893.
  8. Vardiman JW, Thiele J, Arber DA, et al. The 2008 revision of the World Health Organization (WHO) classification of myeloid neoplasms and acute leukemia: rationale and important changes. Blood. 2009; 114(5): 937–951.
  9. Zhao XF, Gojo I, York T, et al. Diagnosis of biphenotypic acute leukemia: a paradigmatic approach. Int J Clin Exp Pathol. 2009; 3(1): 75–86.
  10. Coustan-Smith E, Mullighan CG, Oncui M. Early T-cell precursor leukemia: a subtype of very high-risk acutelymphoblastic leukemia identified in two independent cohorts. Lancet Oncol. 2009; 10(2): 147–156.
  11. Neumann M, Heesch S, Schlee C, et al. Whole-exome sequencing in adult ETP-ALL reveals a high rate of DNMT3A mutations. Blood. 2013; 121(23): 4749–4752.
  12. Neumann M, Coskun E, Fransecky L, et al. FLT3 mutations in early T-cell precursor ALL characterize a stem cell like leukemia and imply the clinical use of tyrosine kinase inhibitors. PLoS One. 2013; 8(1): e53190.
  13. Zhang J, Ding Li, Holmfeldt L, et al. The genetic basis of early T-cell precursor acute lymphoblastic leukaemia. Nature. 2012; 481(7380): 157–163.
  14. van den Ancker W, Terwijn M, Westers TM, et al. Acute leukemias of ambiguous lineage: diagnostic consequences of the WHO2008 classification. Leukemia. 2010; 24(7): 1392–1396.
  15. Munker R, Brazauskas R, Wang HL, et al. Center for International Blood and Marrow Transplant Research. Allogeneic hematopoietic cell transplantation for patients with mixed phenotype acute leukemia. Biol Blood Marrow Transplant. 2016; 22(6): 1024–1029.
  16. Weinberg OK, Arber DA. Mixed-phenotype acute leukemia: historical overview and a new definition. Leukemia. 2010; 24(11): 1844–1851.
  17. Pomerantz A, Rodriguez-Rodriguez S, Demichelis-Gomez R, et al. Mixed-phenotype acute leukemia: suboptimal treatment when the 2008/2016 WHO classification is used. Blood Res. 2016; 51(4): 233–241.
  18. Matutes E, Pickl WF, Van't Veer M, et al. Mixed-phenotype acute leukemia: clinical and laboratory features and outcome in 100 patients defined according to the WHO 2008 classification. Blood. 2011; 117(11): 3163–3171.
  19. Heesch S, Neumann M, Schwartz S, et al. Acute leukemias of ambiguous lineage in adults: molecular and clinical characterization. Ann Hematol. 2013; 92(6): 747–758.
  20. Zhang Y, Wu D, Sun A, et al. Clinical characteristics, biological profile, and outcome of biphenotypic acute leukemia: a case series. Acta Haematol. 2011; 125(4): 210–218.
  21. Liu QF, Fan ZP, Wu MQ, et al. Allo-HSCT for acute leukemia of ambiguous lineage in adults: the comparison between standard conditioning and intensified conditioning regimens. Ann Hematol. 2013; 92(5): 679–687.
  22. Manola KN. Cytogenetic abnormalities in acute leukaemia of ambiguous lineage: an overview. Br J Haematol. 2013; 163(1): 24–39.
  23. Killick S, Matutes E, Powles RL, et al. Outcome of biphenotypic acute leukemia. Haematologica. 1999; 84(8): 699–706.



Hematology in Clinical Practice