Indian Journal of Pathology and Microbiology
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CASE REPORT
Year : 2023  |  Volume : 66  |  Issue : 1  |  Page : 191-195

Lineage switch of acute myeloid leukemia to T-Cell acute lymphoblastic leukemia – A unique case report


1 Department of Pathology, Bhagwan Mahaveer Cancer Hospital and Research Centre, Jaipur, Rajasthan, India
2 Department of Haemato-Oncology, Bhagwan Mahaveer Cancer Hospital and Research Centre, Jaipur, Rajasthan, India
3 Department of Pathology-Haematopathology, Bhagwan Mahaveer Cancer Hospital and Research Centre, Jaipur, Rajasthan, India

Correspondence Address:
Shashi Bansal
Sr. Consultant Pathology, Room No -15, Department of Pathology, Bhagwan Mahaveer Cancer Hospital and Research Centre, Malviya Nagar, Jaipur - 302 017, Rajasthan
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijpm.ijpm_441_21

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“Lineage switch” is term described when leukemic cells on relapse exhibit a new phenotype, where losses of one lineage defining markers with simultaneous gain of another lineage defining markers occur. Relapse of acute leukemia is although a very common event, lineage switch occurs and reported very rarely in such cases. The pathogenesis involved in this phenomenon remains unclear; however plasticity of hematopoietic progenitor affected by intrinsic and extrinsic environmental cues can be a possible explanation. In most of the cases at the time of relapse conversion of B-acute lymphoblastic leukemia (ALL) to acute myeloid leukemia (AML) occurs. Here, we presented an unusual case of 10 year old boy with AML switched to T-ALL upon relapse, which is very rare and not well documented till date in literature. The diagnosis was further supported by morphologic, cytochemistry and flowcytometric immunophenotyping (FCM-IPT). Prognosis and survival of such cases remains poor even by the use of standard chemotherapy.


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