Multilineage Lymphoblastic Lymphoma as an Initial Presentation of Mixed Phenotype Acute Leukemia

Mako Ikeda; Wataru Nakahara; Mizuki Asako; Yuka Umeki; Yoshiki Matsuoka; Takuya Terakawa; Hitomi Matsunaga; Yuki Iwasa; Riko Saito; Yuki Iwama; Takahiro Matsui; Kazumasa Oka; Shuji Ueda

doi:10.1155/2023/3628712

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. eCollection 2023.

Authors

Affiliations

¹ Department of Hematology, Hyogo Prefectural Nishinomiya Hospital, Nishinomiya, Hyogo, Japan.
² Department of Clinical Laboratory, Hyogo Prefectural Nishinomiya Hospital, Nishinomiya, Hyogo, Japan.
³ Department of Radiology, Hyogo Prefectural Nishinomiya Hospital, Nishinomiya, Hyogo, Japan.
⁴ Department of Pathology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
⁵ Department of Pathology, Hyogo Prefectural Nishinomiya Hospital, Nishinomiya, Hyogo, Japan.

Abstract

Mixed phenotype acute leukemia (MPAL) is characterized by leukemic blasts that express markers of multiple lineages. Compared with acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL), MPAL is considered to have a poor treatment outcome. We report a case of MPAL T/myeloid not otherwise specified that was initially presented as multilineage lymphoblastic lymphoma and subsequently developed into leukemic MPAL. An acute lymphoblastic leukemia-based treatment regimen was ineffective, but azacitidine and venetoclax therapy resulted in hematological complete remission. Our case suggests that multilineage lymphoblastic lymphoma should be considered to be the same disease as MPAL, albeit with different clinical presentations. Optimal treatment for MPAL has not been established yet, but azacitidine and venetoclax therapy may be a potential approach.

Publication types

Case Reports