Journal of Korean Medical Science  2011;26(6):829-831

doi:10.3346/jkms.2011.26.6.829

Lineage Switch at Relapse of Childhood Acute Leukemia: A Report of Four Cases.

Meerim PARK 1 ; Kyung Nam KOH ; Bo Eun KIM ; Ho Joon IM ; Seongsoo JANG ; Chan Jeoung PARK ; Hyun Sook CHI ; Jong Jin SEO

Affiliations

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Keywords

Lineage Switch; Acute Leukemia

Country

Republic of Korea

Language

English

Abstract

Lineage switch in acute leukemia is an uncommon event at relapse, and therefore rarely reported in the literature. Here, we have described the clinical laboratory features of four cases in which the cell lineage switched from acute lymphoblastic leukemia (ALL) to acute myeloid leukemia (AML). One patient was initially diagnosed with B-ALL, switched to T-ALL at the first relapse, and eventually, AML at the second relapse. A lineage switch represented either relapse of the original clone with heterogeneity at the morphologic level or emergence of a new leukemic clone. Further sequential phenotypic and cytogenetic studies may yield valuable insights into the mechanisms of leukemic recurrence, with possible implications for treatment selection.