Related Experiment Videos
[Successful treatment with clarithromycin for Mixed phenotype acute leukemia, T/myeloid, NOS]
1Department of General Medicine, Hokkaido Social Insurance Hospital.
Insights
A rare case of mixed phenotype acute leukemia (T/myeloid, NOS) in an elderly woman showed complete remission after treatment with clarithromycin (CAM). This suggests CAM may be an effective therapy for this aggressive leukemia.
Area of Science:
- Hematology
- Oncology
- Immunophenotyping
Background:
- Mixed phenotype acute leukemia (MPAL) is a rare and aggressive hematologic malignancy.
- Accurate diagnosis and effective treatment strategies for MPAL remain challenging.
- This case involves an elderly patient with a complex presentation of lymphadenopathy and leukopenia.
Observation:
- A 79-year-old woman presented with submandibular lymphadenopathy, diagnosed as bacterial and fungal lymphadenitis.
- Initial laboratory findings revealed leukopenia with 7% blasts.
- Bone marrow examination showed approximately 90% blasts with surface antigen expression of cyCD3, TdT, and MPO.
Findings:
- The patient was diagnosed with Mixed phenotype acute leukemia, T/myeloid, NOS.
- Treatment included prednisone for fever and clarithromycin (CAM) for pneumonia.
- Remarkably, three months post-treatment, both bone marrow and peripheral blood smears showed complete disappearance of leukemic cells.
Implications:
- This clinical course suggests that clarithromycin (CAM) may possess significant efficacy against this specific type of mixed phenotype acute leukemia.
- Further investigation into CAM as a therapeutic agent for MPAL is warranted.
- This case highlights the importance of comprehensive diagnostic workup and individualized treatment approaches in hematologic malignancies.
Abstract:
A 79-year-old woman was admitted with submandibular lymphadenopathy and was diagnosed as having bacterial and fungal lymphadenitis by lymph nodal biopsy. Laboratory examination demonstrated leukopenia with 7% blasts. The bone marrow was infiltrated with about 90% blasts and surface antigen analysis of these blasts demonstrated expression of cyCD3, TdT and MPO. The diagnosis was Mixed phenotype acute leukemia, T/myeloid, NOS. The patient was treated with prednisone (10 mg/day) for fever and subsequently CAM (800 mg/day) for pneumonia. Three months later, leukemic cells had disappeared on both bone marrow aspiration and peripheral blood smear. This clinical course suggests CAM is effective for this leukemia.
