Mixed phenotype acute leukemia (MPAL) is a type of acute leukemia in which encompasses mixed features of myeloid, T-lymphoid, and/or B-lymphoid differentiation. Philadelphia chromosome-positive (Ph + ) MPAL is a rare subgroup with a poor prognosis and accounts for <1% of adult acute leukemia. Until now, there is still no consensus on how to best treat Ph + MPAL. Here, we report a 62-year-old male with Ph + (atypical e13a2 BCR-ABL1 fusion protein) MPAL. This patient presented with recurrent and intense bone pain due to bone marrow necrosis (BMN). Besides, he did not achieve a complete remission for the first two chemotherapies, until he received flumatinib combined with hyper-CVAD (B) (a dose-intensive regimen include methotrexate and cytarabine). To our knowledge, this is the first report to describe the coexistence of BMN and atypical e13a2 BCR-ABL1 transcripts in patients with MPAL. This finding will bring new understandings in the diagnosis and treatment of Ph + MPAL.
Keyphrases
- chronic myeloid leukemia
- bone marrow
- tyrosine kinase
- poor prognosis
- acute lymphoblastic leukemia
- long non coding rna
- mesenchymal stem cells
- acute myeloid leukemia
- high dose
- healthcare
- chronic pain
- pain management
- dendritic cells
- case report
- rna seq
- rheumatoid arthritis
- bone mineral density
- single cell
- neuropathic pain
- young adults
- spinal cord
- spinal cord injury
- genome wide
- open label