Sheng XF, Hong LL, Huang FY, Zhuang HF. Acute myeloid leukemia with myelodysplasia-related changes and blasts of the mixed T/myeloid phenotype: a case report.
J Int Med Res 2022;
50:3000605221122741. [PMID:
36134564 PMCID:
PMC9500278 DOI:
10.1177/03000605221122741]
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Abstract
A rare but clinically important diagnostic dilemma arises when cases meet the criteria
for both acute myeloid leukemia with myelodysplasia-related changes (AML-MRC) and mixed
phenotype acute leukemia, especially those that evolve from myelodysplastic syndrome. We
describe a 56-year-old male patient who presented with cytopenias and was initially
diagnosed with myelodysplastic syndrome with single lineage dysplasia. Nearly 1 year
later, this patient progressed to acute leukemia, and his blast cells simultaneously
expressed T-lymphoid and myeloid antigens. Cytogenetic analysis showed a 20q deletion, and
next-generation sequencing showed mutations of ASXL1, NRAS, PHF6, RUNX1, TP53, and PIGA.
He was diagnosed with AML-MRC with blasts of the mixed T/myeloid phenotype according to
the latest World Health Organization guidelines. In accordance with the treatment
principles of AML-MRC, we chose an AML-like regimen for four cycles, but the patient did
not achieve remission. Finally, we adhered to the treatment principles of mixed phenotype
acute leukemia, and he achieved remission after a course of ALL-like regimen
chemotherapy.
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