1. [Acute leukemia of ambiguous lineage with monosomy 7 and Philadelphia chromosome].
- Author
-
Kawasaki Y, Nakazora T, Suzukawa M, Tominaga T, and Shinohara K
- Subjects
- Acute Disease, Aged, Antineoplastic Agents adverse effects, Antineoplastic Agents therapeutic use, Benzamides, Chromosome Deletion, Chromosomes, Human, Pair 7 genetics, Diagnosis, Differential, Fatal Outcome, Female, Heart Failure chemically induced, Humans, Imatinib Mesylate, Leukemia diagnosis, Leukemia pathology, Leukemia therapy, Piperazines adverse effects, Piperazines therapeutic use, Pyrimidines adverse effects, Pyrimidines therapeutic use, Leukemia genetics, Philadelphia Chromosome
- Abstract
A 67-year-old female was admitted with a diagnosis of acute leukemia. Immature blasts did not show cytoplasmic granules and were POX(-), ES(-), and PAS(+). Flow cytometry of leukemic cells demonstrated positivity for CD7, CD10, CD19, CD13, CD34, HLA-DR, and coexpression of CD7 and CD34, CD10 and HLA-DR, and CD19 and CD13. Cytogenetic analysis demonstrated -7 and t(9;22)(q34;q11.2), and genomic studies demonstrated minor BCR/ABL chimeric mRNA and rearrangements of IgH and TCR. These findings indicated the clonal proliferation of leukemic blasts that expressed a mixed phenotype. Acute leukemia of ambiguous lineage was diagnosed, although the significance of the specificity of lineage markers remains unclear. The differential diagnosis included CML and B-ALL. The patient was treated according to Ph+ALL. However, the hematological response was poor, with persistent residual blasts and severe pancytopenia. The subsequent administration of imatinib mesylate led to a complication of heart failure, and the patient died on the 19th hospital day.
- Published
- 2011