Lineage Assignment in Acute Leukemia: A Challenging Case in a Pediatric Patient

Karine Turcotte, Stefanie Lowas, Sachit A. Patel, Deborah A. Perry, Catalina Amador, Samuel J. Pirruccello, Kai Fu

Research output: Contribution to journalArticlepeer-review


We report a case of a 2-year-old girl who was diagnosed with natural killer cell acute lymphoblastic leukemia and treated with an acute lymphoblastic leukemia chemotherapy regimen. Two months posttherapy, the disease relapsed with a myeloid immunophenotype. Complete response was then achieved with acute myeloid leukemia therapy followed by unrelated donor umbilical cord allogenic stem cell transplant. Retrospectively, reanalysis of the diagnostic specimen showed minimal myeloperoxidase expression that was called negative by conventional single parameter linear gating but better appreciated on histogram overlays. This case illustrates that even low levels of myeloperoxidase expression should be considered significant in lineage assignment in acute leukemia.

Original languageEnglish (US)
Pages (from-to)E109-E114
JournalJournal of Pediatric Hematology/Oncology
Issue number1
StatePublished - Jan 2021


  • mixed phenotype acute leukemia
  • natural killer cell lymphoblastic leukemia/lymphoma

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology


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