Abstract
Acute leukemia of mixed phenotype (MPAL) is a rare group of neoplasms in which blast cells exhibit characteristics of more than one hematopoietic cell line. The term lymphoma is used when the primary lesion is located in an extramedullary site, such as a lymph node, with no or minimal evidence (<25%) of peripheral blood or bone marrow involvement. Most MPAL cases present as leukemia; therefore, several of the current diagnostic criteria in the World Health Organization (WHO) classification are difficult to apply to tissue samples. It primarily affects children and adolescents, and its diagnosis, classification, and treatment selection generate significant challenges. We report a case of a pediatric patient diagnosed with lymphoblastic lymphoma of mixed lineage, along with his treatment and evolution.
References
Martin-Guerrero I, Salaverria I, Burkhardt B et al. Non-leukemic pediatric mixed phenotype acute leukemia/lymphoma: Genomic characterization and clinical outcome in a prospective trial for pediatric lymphoblastic lymphoma. Genes Chromosomes Cancer. 2019 Jun;58(6):365-372. doi: 10.1002/gcc.22726.
Batra S, Ross AJ. Pediatric Mixed-Phenotype Acute Leukemia: What's New? Cancers (Basel). 2021 Sep 16;13(18):4658. doi: 10.3390/cancers13184658.
Wolach O, Stone RM. Optimal therapeutic strategies for mixed phenotype acute leukemia. Curr Opin Hematol. 2020 Mar;27(2):95-102. doi: 10.1097/MOH.0000000000000570.
Wolach O, Stone RM. How I treat mixed-phenotype acute leukemia. Blood. 2015 Apr 16;125(16):2477-85. doi: 10.1182/blood-2014-10-551465.
Hrusak O, de Haas V, Stancikova J et al. International cooperative study identifies treatment strategy in childhood ambiguous lineage leukemia. Blood. 2018 Jul 19;132(3):264-276. doi: 10.1182/blood-2017-12-821363.
Orgel E, Alexander TB, Wood BL et al; Children's Oncology Group Acute Leukemia of Ambiguous Lineage Task Force. Mixed-phenotype acute leukemia: A cohort and consensus research strategy from the Children's Oncology Group Acute Leukemia of Ambiguous Lineage Task Force. Cancer. 2020 Feb 1;126(3):593-601. doi: 10.1002/cncr.32552.
Ikeda M, Nakahara W, Asako M et al. Multilineage Lymphoblastic Lymphoma as an Initial Presentation of Mixed Phenotype Acute Leukemia. Case Rep Hematol. 2023 Feb 25;2023:3628712. doi: 10.1155/2023/3628712.
Childhood Acute Lymphoblastic Leukemia Treatment (PDQ®) (2024, September 6). https://www.cancer.gov/types/leukemia/hp/child-all-treatment-pdq
Mejstrikova E, Volejnikova J, Fronkova E et al. Prognosis of children with mixed phenotype acute leukemia treated on the basis of consistent immunophenotypic criteria. Haematologica. 2010 Jun;95(6):928-35. doi: 10.3324/haematol.2009.014506.
All material published in the journal HEMATOLOGÍA (electronic and print version) is transferred to the Argentinean Society of Hematology. In accordance with the copyright Act (Act 11 723), a copyright transfer form will be sent to the authors of approved works, which has to be signed by all the authors before its publication. Authors should keep a copy of the original since the journal is not responsible for damages or losses of the material that was submitted. Authors should send an electronic version to the email: revista@sah.org.ar
