Case Report

Acute myelogenous leukemia switch lineage upon relapse to acute lymphoblastic leukemia: a case report

Elisa Dorantes-Acosta¹ , Farina Arreguin-Gonzalez¹ , Carlos A Rodriguez-Osorio² , Stanislaw Sadowinski³ , Rosana Pelayo⁴ and Aurora Medina-Sanson¹

¹  Department of Pediatric Hematology and Oncology, Hospital Infantil de Mexico Federico Gomez, Mexico City, Mexico

²  Department of Critical Care Medicine, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico

³  Department of Pathology, Hospital Infantil de Mexico Federico Gomez, Mexico City, Mexico

⁴  Oncology Research Unit, Oncology Hospital, National Medical Center, IMSS, Mexico City, Mexico

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Cases Journal 2009, 2:154doi:10.1186/1757-1626-2-154

Published:	15 October 2009

Abstract

Acute leukemia, the most common form of cancer in children, accounts for approximately 30% of all childhood malignancies, with acute lymphoblastic leukemia being five times more frequent than acute myeloid leukemia. Lineage switch is the term that has been used to describe the phenomenon of acute leukemias that meet the standard French-American-British system criteria for a particular lineage (either lymphoid or myeloid) upon initial diagnosis, but meet the criteria for the opposite lineage at relapse. Many reports have documented conversions of acute lymphoblastic leukemia to acute myeloid leukemia.

Here, we report the case of a 4-year-old child with acute myeloid leukemia, which upon relapse switched to acute lymphoblastic leukemia. The morphologic, phenotypic, and molecular features suggest the origin of a new leukemic clone.