Acute Leukemia with Rearrangement: A Master of Disguise

Overview

Journal Leuk Res Rep

Date 2024 Jun 21

PMID 38903873

Authors

Sawyer J Bawek

Eunice S Wang

Steven D Green

Affiliations

Soon will be listed here.

Abstract

Mixed-phenotype acute leukemia (MPAL) is a rare form of leukemia with ambiguous lineage, and there are challenges in accurately diagnosing this entity according to formal criteria. Here we report a case which was initially diagnosed as "AML" based on atypical peripheral blood flow cytometry that was subsequently determined to be B-ALL with rearrangement based on marrow results. Although rearrangements represent a defining genetic abnormality for acute leukemia of ambiguous lineage, this case did not meet the criteria for MPAL based on WHO 2022 criteria. This case highlights the diagnostic challenges of MPAL and the potential limitations of the current classification. We discuss the most appropriate workup and management of these patients and identify areas for future study.

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