Acute T-lymphoblastic leukemia relapsed with the character of myeloid/natural killer cell precursor phenotype: a case report

• Published in: Leukemia research 2002-02, Vol.26 (2), p.215-219
• Main Authors: Hashimoto, Shigeo, Toba, Ken, Aoki, Sadao, Tsuchiyama, Junjiro, Tsukada, Nobuhiro, Takahashi, Hidenobu, Takahashi, Masuhiro, Aizawa, Yoshifusa
• Format: Article
• Language: English
• Subjects: Acute leukemia; Antigens, CD - analysis; Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Bone Marrow Transplantation; CD3ε; CD56; Cell Lineage; Combined Modality Therapy; Daunorubicin - administration & dosage; Disease Progression; Fatal Outcome; Gene Rearrangement, beta-Chain T-Cell Antigen Receptor; Genes, Immunoglobulin; Glycophorin - analysis; Hematologic and hematopoietic diseases; HLA-DR Antigens - analysis; Humans; Immunophenotyping; Killer Cells, Natural - chemistry; Killer Cells, Natural - pathology; Leukemia, Lymphoid - drug therapy; Leukemia, Lymphoid - pathology; Leukemia, Lymphoid - radiotherapy; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Male; Medical sciences; Methotrexate - therapeutic use; Myeloid Cells - chemistry; Myeloid Cells - pathology; Myeloid/natural killer cell precursor acute leukemia; Neoplasm Proteins - analysis; Neoplastic Stem Cells - chemistry; Peroxidase - analysis; Prednisolone - administration & dosage; Pro-T lymphoblast; Recurrence; Remission Induction; T-acute lymphoblastic leukemia; T-Lymphocyte Subsets - chemistry; T-Lymphocyte Subsets - pathology; Transplantation, Homologous; Vincristine - administration & dosage
• ISSN: 0145-2126; 1873-5835
• DOI: 10.1016/S0145-2126(01)00088-1

The leukemic lymphoblasts of a patient expressed CD7, CD13, CD33, CD34, HLA-DR and cytoplasmic CD3ε. He was diagnosed with acute lymphoblastic leukemia (ALL), and successfully treated with a conventional chemotherapy for ALL. The disease relapsed three times, and the character of the cells gradually altered, i.e. CD56 expression increased and CD13, CD7 and cCD3ε decreased. The phenotype of the relapsed ALL was, therefore, compatible with myeloid/natural killer cell precursor acute leukemia (M/NK-AL). Some of M/NK-AL may be closely related with T/myeloid-biphenotypic pro-T blasts, and both types of acute leukemia may develop a tendency to express myeloid antigens, and they may belong to the category of immature T lymphoid precursors.