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

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.

Extramedullary mixed phenotypic (B/T) lymphoblastic lymphoma of scalp: A rare case with unique presentation

“…After extensive search, we found only 25 cases of extramedullary mixed phenotypic hematolymphoid neoplasms reported so far, of which 12 cases were B/myeloid, 10 were T/myeloid, and only three were (B/T). 4,[7][8][9][10][11] Our case is the 4th one to be reported amongst (B/T) category (Table 1).…”