Clinical laboratory · 2025
Lineage Switch from Acute Lymphoblastic Leukemia to Acute Myeloid Leukemia with PDGFRB Mutation after Allogeneic Stem Cell Transplantation.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Yu Hongjuan, Qi Xuefen, Zhang Jifei, He Lingrong
Аннотация
BACKGROUND: The goal was to investigate the clinical characteristics of acute T-lymphoblastic leukemia (T-ALL) transforming into acute myeloid leukemia (AML) and to provide a basis for improved clinical diagnosis and treatment of this condition.
METHODS: A retrospective analysis was performed on the clinical data and treatment process of a patient with T-ALL who transitioned to AML after undergoing allogeneic hematopoietic stem cell transplantation. Relevant literature was also reviewed.
RESULTS: The patient, a 24-year-old female, initially presented with fatigue. A comprehensive examination confirmed the diagnosis of T-ALL. Following induction chemotherapy, the patient achieved complete remission (CR) as determined by hematologic and cytogenetic assessments. The patient subsequently underwent allogeneic hema-topoietic stem cell transplantation from a sibling donor. Six months post-transplantation, bone marrow cytology indicated a relapse, with morphology and immunophenotype consistent with AML. The patient is currently in the terminal stage of a malignant tumor, with a very poor prognosis.
CONCLUSIONS: Lineage switching following acute leukemia relapse is associated with a poor prognosis, necessitating treatment adjustments based on the post-relapse phenotype. Clinically, for recurrent leukemia, comprehensive evaluations-including leukemia immunophenotyping, gene mutation analysis, and cytogenetic and molecular biological examinations-are essential to better guide treatment and assess prognosis.
METHODS: A retrospective analysis was performed on the clinical data and treatment process of a patient with T-ALL who transitioned to AML after undergoing allogeneic hematopoietic stem cell transplantation. Relevant literature was also reviewed.
RESULTS: The patient, a 24-year-old female, initially presented with fatigue. A comprehensive examination confirmed the diagnosis of T-ALL. Following induction chemotherapy, the patient achieved complete remission (CR) as determined by hematologic and cytogenetic assessments. The patient subsequently underwent allogeneic hema-topoietic stem cell transplantation from a sibling donor. Six months post-transplantation, bone marrow cytology indicated a relapse, with morphology and immunophenotype consistent with AML. The patient is currently in the terminal stage of a malignant tumor, with a very poor prognosis.
CONCLUSIONS: Lineage switching following acute leukemia relapse is associated with a poor prognosis, necessitating treatment adjustments based on the post-relapse phenotype. Clinically, for recurrent leukemia, comprehensive evaluations-including leukemia immunophenotyping, gene mutation analysis, and cytogenetic and molecular biological examinations-are essential to better guide treatment and assess prognosis.