T-cell acute lymphoblastic leukemia relapsing as acute myelogenous leukemia.
We present the unusual case of a 16-year-old girl with T-cell acute lymphoblastic leukemia (ALL) with an early thymocyte immunophenotype without myeloid markers, who after 13 months of complete hematological remission relapsed as acute myelogenous leukemia (AML) with minimal differentiation and died of her disease. Whether the AML represented a relapse with lineage switch of the original immature T-cell clone or a new secondary malignancy, could not be proven due to the absence of molecular or clonal markers. This report suggests that a subset of CD7+ T-cell leukemias without mature T-cell antigens (CD4-, CD8-) are minimally differentiated and can relapse as AML.
Mantadakis
Elpis
E
Department of Pediatric Hematology/Oncology, University Hospital of Heraklion, Heraklion, Crete, Greece.
Danilatou
Vassiliki
V
Stiakaki
Eftichia
E
Paterakis
George
G
Papadhimitriou
Stefanos
S
Kalmanti
Maria
M
D000208:Acute Disease; D000293:Adolescent; D019011:Antigens, CD7 / Q000032:analysis; D000945:Antigens, Differentiation, T-Lymphocyte / Q000032:analysis*; D000951:Antigens, Neoplasm / Q000032:analysis*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D001215:Asparaginase / Q000008:administration & dosage; D001853:Bone Marrow / Q000473:pathology; D002454:Cell Differentiation; D019070:Cell Lineage; D050676:Core Binding Factor Alpha 2 Subunit / Q000235:genetics; D003520:Cyclophosphamide / Q000008:administration & dosage; D003561:Cytarabine / Q000008:administration & dosage; D003630:Daunorubicin / Q000008:administration & dosage; D003907:Dexamethasone / Q000008:administration & dosage; D003937:Diagnosis, Differential; D004317:Doxorubicin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects; D017809:Fatal Outcome; D005260:Female; D018628:Gene Dosage; D011495:Histone-Lysine N-Methyltransferase; D006801:Humans; D016130:Immunophenotyping; D007621:Karyotyping; D007951:Leukemia, Myeloid / Q000175:diagnosis / Q000235:genetics / Q000473:pathology*; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000188:drug therapy / Q000235:genetics / Q000473:pathology*; D015122:Mercaptopurine / Q000008:administration & dosage; D008727:Methotrexate / Q000008:administration & dosage; D051788:Myeloid-Lymphoid Leukemia Protein / Q000235:genetics; D016609:Neoplasms, Second Primary / Q000175:diagnosis; D014411:Neoplastic Stem Cells / Q000473:pathology*; D011519:Proto-Oncogenes; D012008:Recurrence; D016176:T-Lymphocyte Subsets / Q000737:chemistry / Q000473:pathology*; D014750:Vincristine / Q000008:administration & dosage
D019011:Antigens, CD7; D000945:Antigens, Differentiation, T-Lymphocyte; D000951:Antigens, Neoplasm; D050676:Core Binding Factor Alpha 2 Subunit; C497422:KMT2A protein, human; C493728:RUNX1 protein, human; D003561:Cytarabine; D051788:Myeloid-Lymphoid Leukemia Protein; D014750:Vincristine; D005047:Etoposide; D003907:Dexamethasone; D004317:Doxorubicin; D003520:Cyclophosphamide; D015122:Mercaptopurine; D011495:Histone-Lysine N-Methyltransferase; D001215:Asparaginase; D008727:Methotrexate; D003630:Daunorubicin