Alexandra MARCOCI, Raluca Mihaela MANOLACHE, Radu Bogdan FLORESCU, Doina BARBU, Florentina GRADINARU, Silvana ANGELESCU, Cristina MAMBET, Cerasela JARDAN, Nicoleta Mariana BERBEC, Andrei COLITA
Lineage switch in acute leukemias is considered a rare event, especially in what concerns adult disease compared to pediatric patients. Differential diagnosis between biphenotypic/bilineal leukemias, de novo leukemias, therapy-related and phenotype switch variants, stands as an intricate challenge. Complementary laboratory studies and complex laboratory assays (conventional karyotyping, FISH- fluorescence in situ hybridization, molecular biology, immunophenotyping, etc.) represent one of the crucial resources regarding the process of establishing an accurate diagnosis, thus having a firm ground for the most beneficial treatment choice. Aim: To emphasize the diagnostic and therapeutic particularities regarding the case of a female patient with acute lymphoblastic leukemia (ALL) who later developed a phenotype switch towards an intermediary form of acute myeloid leukemia (AML), sharing features of both AML with maturation and atypical acute promyelocytic leukemia (AML M2/M3/APL).