T-cell acute lymphoblastic leukemia relapsing as acute myelogenous leukemia

• Published in: Pediatric Blood & Cancer 2007-03, Vol.48 (3), p.354-357
• Main Authors: Mantadakis, Elpis, Danilatou, Vassiliki, Stiakaki, Eftichia, Paterakis, George, Papadhimitriou, Stefanos, Kalmanti, Maria
• Format: Article
• Language: English
• Subjects: Acute Disease; Adolescent; Antigens, CD7 - analysis; Antigens, Differentiation, T-Lymphocyte - analysis; Antigens, Neoplasm - analysis; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Asparaginase - administration & dosage; Bone Marrow - pathology; Cell Differentiation; Cell Lineage; Core Binding Factor Alpha 2 Subunit - genetics; Cyclophosphamide - administration & dosage; Cytarabine - administration & dosage; Daunorubicin - administration & dosage; Dexamethasone - administration & dosage; Diagnosis, Differential; Doxorubicin - administration & dosage; Etoposide - administration & dosage; Etoposide - adverse effects; Fatal Outcome; Female; Gene Dosage; Histone-Lysine N-Methyltransferase; Humans; Immunophenotyping; Karyotyping; Leukemia, Myeloid - diagnosis; Leukemia, Myeloid - genetics; Leukemia, Myeloid - pathology; Leukemia-Lymphoma, Adult T-Cell - drug therapy; Leukemia-Lymphoma, Adult T-Cell - genetics; Leukemia-Lymphoma, Adult T-Cell - pathology; Mercaptopurine - administration & dosage; Methotrexate - administration & dosage; myelogenous leukemia; Myeloid-Lymphoid Leukemia Protein - genetics; Neoplasms, Second Primary - diagnosis; Neoplastic Stem Cells - pathology; Proto-Oncogenes; Recurrence; secondary leukemia; T-cell acute lymphoblastic leukemia; T-Lymphocyte Subsets - chemistry; T-Lymphocyte Subsets - pathology; T-stem cell leukemia; Vincristine - administration & dosage
• ISSN: 1545-5009; 1545-5017; 1096-911X
• DOI: 10.1002/pbc.20543

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. Pediatr Blood Cancer 2007;48:354–357. © 2005 Wiley‐Liss, Inc.