Mixed-phenotype Acute Leukemia with Trilineage Differentiation in a 3-year-old Child

Mixed-phenotype acute leukemia (MPAL) is characterized by the expression of markers from multiple hematopoietic lineages, including myeloid, B-cell, and T-cell origins. This case report describes a 3-year, 8-month-old girl who presented with swelling in both eyes, initially accompanied by lumps on t...

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Main Authors: I Gusti Ayu Mardewi, Anak Agung Wiradewi Lestari, I Nyoman Wande, Ni Nyoman Mahartini
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2024-12-01
Series:Journal of Applied Hematology
Subjects:
Online Access:https://journals.lww.com/10.4103/joah.joah_81_24
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author I Gusti Ayu Mardewi
Anak Agung Wiradewi Lestari
I Nyoman Wande
Ni Nyoman Mahartini
author_facet I Gusti Ayu Mardewi
Anak Agung Wiradewi Lestari
I Nyoman Wande
Ni Nyoman Mahartini
author_sort I Gusti Ayu Mardewi
collection DOAJ
description Mixed-phenotype acute leukemia (MPAL) is characterized by the expression of markers from multiple hematopoietic lineages, including myeloid, B-cell, and T-cell origins. This case report describes a 3-year, 8-month-old girl who presented with swelling in both eyes, initially accompanied by lumps on the neck and a fever that subsided with antipyretics. After the neck lumps resolved, eye swelling began in the right eye and later progressed to the left eye. Bone marrow aspiration confirmed the presence of mixed-lineage leukemia, revealing myeloblasts with Auer rod, monoblast, and lymphoblast. Leukemia phenotyping identified a mixed lineage involving myeloid, B-cell, and T-cell markers, supporting the diagnosis of MPAL. The patient was treated according to the acute lymphoblastic leukemia induction therapy protocol with vincristine and daunorubicin, and fluid hydration and allopurinol were taken to prevent tumor lysis syndrome. This case highlights the diagnostic complexity and need for a comprehensive treatment approach in managing MPAL.
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institution Kabale University
issn 1658-5127
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language English
publishDate 2024-12-01
publisher Wolters Kluwer Medknow Publications
record_format Article
series Journal of Applied Hematology
spelling doaj-art-33bacb64382a472d93807428aaa61c312025-01-10T11:14:49ZengWolters Kluwer Medknow PublicationsJournal of Applied Hematology1658-51272454-69762024-12-0115431932510.4103/joah.joah_81_24Mixed-phenotype Acute Leukemia with Trilineage Differentiation in a 3-year-old ChildI Gusti Ayu MardewiAnak Agung Wiradewi LestariI Nyoman WandeNi Nyoman MahartiniMixed-phenotype acute leukemia (MPAL) is characterized by the expression of markers from multiple hematopoietic lineages, including myeloid, B-cell, and T-cell origins. This case report describes a 3-year, 8-month-old girl who presented with swelling in both eyes, initially accompanied by lumps on the neck and a fever that subsided with antipyretics. After the neck lumps resolved, eye swelling began in the right eye and later progressed to the left eye. Bone marrow aspiration confirmed the presence of mixed-lineage leukemia, revealing myeloblasts with Auer rod, monoblast, and lymphoblast. Leukemia phenotyping identified a mixed lineage involving myeloid, B-cell, and T-cell markers, supporting the diagnosis of MPAL. The patient was treated according to the acute lymphoblastic leukemia induction therapy protocol with vincristine and daunorubicin, and fluid hydration and allopurinol were taken to prevent tumor lysis syndrome. This case highlights the diagnostic complexity and need for a comprehensive treatment approach in managing MPAL.https://journals.lww.com/10.4103/joah.joah_81_24mixed-phenotype acute leukemiapediatric leukemiatrilineage differentiation
spellingShingle I Gusti Ayu Mardewi
Anak Agung Wiradewi Lestari
I Nyoman Wande
Ni Nyoman Mahartini
Mixed-phenotype Acute Leukemia with Trilineage Differentiation in a 3-year-old Child
Journal of Applied Hematology
mixed-phenotype acute leukemia
pediatric leukemia
trilineage differentiation
title Mixed-phenotype Acute Leukemia with Trilineage Differentiation in a 3-year-old Child
title_full Mixed-phenotype Acute Leukemia with Trilineage Differentiation in a 3-year-old Child
title_fullStr Mixed-phenotype Acute Leukemia with Trilineage Differentiation in a 3-year-old Child
title_full_unstemmed Mixed-phenotype Acute Leukemia with Trilineage Differentiation in a 3-year-old Child
title_short Mixed-phenotype Acute Leukemia with Trilineage Differentiation in a 3-year-old Child
title_sort mixed phenotype acute leukemia with trilineage differentiation in a 3 year old child
topic mixed-phenotype acute leukemia
pediatric leukemia
trilineage differentiation
url https://journals.lww.com/10.4103/joah.joah_81_24
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AT anakagungwiradewilestari mixedphenotypeacuteleukemiawithtrilineagedifferentiationina3yearoldchild
AT inyomanwande mixedphenotypeacuteleukemiawithtrilineagedifferentiationina3yearoldchild
AT ninyomanmahartini mixedphenotypeacuteleukemiawithtrilineagedifferentiationina3yearoldchild