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Lineage switch and translocation t(9;11) in acute leukemia
S Van Lierde1, C Mecucci, M Casteels-Van Daele
1Department of Pediatrics, University Hospital Gasthuisberg, University of Leuven, Belgium.
The American Journal of Pediatric Hematology/Oncology
|January 1, 1989
Summary
A boy experienced a rare lineage switch from acute lymphoblastic leukemia (ALL) to acute myeloid leukemia (AML) upon relapse. This AML relapse was characterized by specific genetic markers, including a translocation (9;11).
Area of Science:
- Hematology
- Oncology
- Molecular Biology
Background:
- Acute lymphoblastic leukemia (ALL) can rarely transform into acute myeloid leukemia (AML) at relapse, a phenomenon known as lineage switch.
- Understanding the mechanisms and characteristics of such lineage switches is crucial for optimizing treatment strategies.
Observation:
- A case report details a pediatric patient initially diagnosed with acute lymphoblastic leukemia (ALL).
- At the time of relapse, the patient presented with acute myeloid leukemia (AML), indicating a lineage switch.
- The AML blasts were predominantly My 9 positive and, upon second relapse, exhibited a characteristic translocation (9;11) (p21;q23).
Findings:
- The study documents a rare instance of lineage switch from ALL to AML in a relapsed pediatric patient.
- The relapsed AML was characterized by My 9 positivity and the presence of a t(9;11) translocation, typical of myelomonocytic leukemia.
- The genetic findings at relapse provide insights into the biological underpinnings of leukemia lineage plasticity.
Implications:
- This case highlights the importance of re-evaluating leukemia diagnosis and immunophenotype at relapse.
- The presence of specific translocations like t(9;11) in relapsed AML may influence therapeutic decisions.
- Further research into the mechanisms of lineage switching in acute leukemia is warranted to improve patient outcomes.