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