title: Erythroleukemia relapsing as precursor B-cell lymphoblastic leukemia.
abstract: AML relapsing as ALL has rarely been reported. We describe the case of a 62-yr-old man who was diagnosed with erythroleukemia with a complex karyotype and achieved complete hematologic and cytogenetic remission after induction chemotherapy. However, 4 months after the initial diagnosis, he showed relapse with blasts showing a different morphology and immunophenotype and was diagnosed with precursor B-cell ALL. The relapsing precursor B-cell ALL presented with the same leukemic clones as the primary erythroleukemia. Cytogenetic analysis of his bone marrow (BM) at the time of the primary erythroleukemia showed complex karyotypic abnormalities, including monosomy 5 and monosomy 7. At relapse, his BM showed reemergence of these leukemic clones of complex karyotypic abnormalities with clonal switch. To our knowledge, this is the first case of a lineage switch from erythroleukemia to ALL.
authors.affiliation: Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea.
authors.forename: Borae G
authors.initials: BG
authors.lastname: Park
authors.forename: Chan-Jeoung
authors.initials: CJ
authors.lastname: Park
authors.forename: Seongsoo
authors.initials: S
authors.lastname: Jang
authors.forename: Eul Ju
authors.initials: EJ
authors.lastname: Seo
authors.forename: Hyun-Sook
authors.initials: HS
authors.lastname: Chi
authors.forename: Jung-Hee
authors.initials: JH
authors.lastname: Lee
mesh_terms: D000208:Acute Disease; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D001854:Bone Marrow Cells / Q000473:pathology; D019070:Cell Lineage; D002471:Cell Transformation, Neoplastic; D002872:Chromosome Deletion; D002895:Chromosomes, Human, Pair 5; D002897:Chromosomes, Human, Pair 7; D003561:Cytarabine / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D006801:Humans; D016130:Immunophenotyping; D007621:Karyotyping; D004915:Leukemia, Erythroblastic, Acute / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D009006:Monosomy; D009279:Naphthacenes / Q000627:therapeutic use; D015452:Precursor B-Cell Lymphoblastic Leukemia-Lymphoma / Q000175:diagnosis* / Q000473:pathology; D012008:Recurrence
chemical_list: D000964:Antimetabolites, Antineoplastic; D009279:Naphthacenes; D003561:Cytarabine; C019318:daunomycinone