Affiliation:
1. Department of Hematology Shandong Provincial Hospital Affiliated to Shandong First Medical University Jinan Shandong China
2. Department of Hematology, Shandong Provincial Hospital Shandong University Jinan Shandong China
Abstract
AbstractMixed 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.