A rare case of mixed phenotype acute leukemia: Acute myeloid leukemia to early T-cell precursor acute lymphoblastic leukemia transformation

Jasmin Rahesh MBA, MS, Arham Siddiqui MBA, Praveen Tumula MD, Rahul Chandra MD

ABSTRACT

Mixed phenotype acute leukemia (MPAL) is comprised of both lymphoid and myeloid markers or blasts in a cell single population. Diagnostic criteria rely on classifications provided by identifying these lineages using cytogenetic markers taken throughout the disease course. We describe an interesting presentation of a patient who had first presented with acute myeloid leukemia (AML) which later transformed into early precursor T-cell acute lymphoblastic leukemia (ETP-ALL). Cytogenetics were taken throughout the course of the cancer and confirmed the presence of a CD34 precursor cell marker. This transformation and the 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 an initial partial response to AML therapy due to clonal evolution.

Keywords: Mixed phenotype acute leukemia; ETP-ALL; AML; MPAL


Article citation: Rahesh J, Siddiqui A, Tumula P, Chandra R. A rare case of mixed phenotype acuteleukemia: Acute myeloid leukemia to early T-cell precursor acute lymphoblastic leukemia transformation. The Southwest Respiratory and Critical Care Chronicles 2022;10(44):45–47
From: Department of Internal Medicine, Texas Tech University Health Sciences Center, Amarillo, Texas
Submitted: 12/20/2021
Accepted: 5/15/2022
Conflicts of interest: none
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