A rare case of mixed phenotype acute leukemia: acute myeloid leukemia to early T-cell precursor acute lymphoblastic leukemia transformation
Mixed phenotypic acute leukemia (MPAL) comprises of both lymphoid and myeloid markers or blasts in a single population. Diagnostic criteria hinges on classifications provided by identifying these lineages based on cytogenetic markers taken throughout the disease course. We describe an interesting presentation of a patient who had first presented with Acute Myeloid leukemia (AML) but 8 weeks later transformed into Early precursor T cell ALL (ETP-ALL). Cytogenetics were taken throughout the course of the cancer and confirmed the presence of a CD34 precursor cell marker. This transformation and cytogenic markers indicated a pluripotent progenitor cell origin confirming the diagnosis of MAPL. This case highlights a pluripotent progenitor origin with initial presentation as AML (myeloid clone) and later as ALL after initial partial response to AML therapy due to clonal evolution.
Copyright (c) 2022 Jasmin Rahesh, Arham Siddiqui, Praveen Tumula, Rahul Chandra
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