title: Acute biphenotypic leukemia arising in a patient with essential thrombocythemia.
abstract: Acute leukemia is an uncommon complication of patients with essential thrombocythemia (ET). We describe a patient with ET, who transformed to acute biphenotypic leukemia 4 and 1/2 years after initial ET diagnosis. She had received hydroxyurea, anagrelide, and interferon, in different combinations and varying doses, before leukemic transformation. Acute biphenotypic leukemia was confirmed on bone marrow studies and immunophenotyping. Complete remission (CR) was achieved with induction chemotherapy for acute leukemia. This was followed with consolidation chemotherapy and the patient has remained in CR 9 months after initial induction chemotherapy. To our knowledge, this is a rare event of acute biphenotypic leukemic transformation of a patient with ET.
authors.affiliation: Department of Hematology, Singapore General Hospital, Singapore. ghewgc@sgh.com.sg
authors.forename: Gee Chuan
authors.initials: GC
authors.lastname: Wong
authors.forename: Lai Heng
authors.initials: LH
authors.lastname: Lee
mesh_terms: D000208:Acute Disease; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects; D002869:Chromosome Aberrations; D002890:Chromosomes, Human, Pair 20 / Q000235:genetics*; D020732:Cytogenetic Analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006918:Hydroxyurea / Q000009:adverse effects / Q000627:therapeutic use; D007938:Leukemia / Q000150:complications* / Q000188:drug therapy / Q000235:genetics*; D008875:Middle Aged; D011799:Quinazolines / Q000009:adverse effects / Q000627:therapeutic use; D012074:Remission Induction; D013920:Thrombocythemia, Essential / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D016896:Treatment Outcome
chemical_list: D011799:Quinazolines; C021139:anagrelide; D006918:Hydroxyurea