J Korean Med Sci.  2011 Jun;26(6):829-831. 10.3346/jkms.2011.26.6.829.

Lineage Switch at Relapse of Childhood Acute Leukemia: A Report of Four Cases

• Park M
• Koh KN
• Kim BE
• Im HJ
• Jang S
• Park CJ
• Chi HS
• Seo JJ

• KMID: 1785972
• DOI: http://doi.org/10.3346/jkms.2011.26.6.829

Abstract

Lineage switch in acute leukemia is an uncommon event at relapse, and therefore rarely reported in the literature. Here, we have described the clinical laboratory features of four cases in which the cell lineage switched from acute lymphoblastic leukemia (ALL) to acute myeloid leukemia (AML). One patient was initially diagnosed with B-ALL, switched to T-ALL at the first relapse, and eventually, AML at the second relapse. A lineage switch represented either relapse of the original clone with heterogeneity at the morphologic level or emergence of a new leukemic clone. Further sequential phenotypic and cytogenetic studies may yield valuable insights into the mechanisms of leukemic recurrence, with possible implications for treatment selection.

Keyword

Lineage Switch; Acute Leukemia

MeSH Terms

Acute Disease
Bone Marrow/pathology
Cell Lineage
Child
Chromosome Aberrations
Female
Hematopoietic Stem Cell Transplantation
Humans
Immunophenotyping
Infant
Leukemia, Myeloid, Acute/*diagnosis/drug therapy/pathology
Male
Precursor Cell Lymphoblastic Leukemia-Lymphoma/*diagnosis/drug therapy/pathology
Recurrence
Salvage Therapy
Transplantation, Homologous

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