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Double Lineage Switch from Acute Megakaryoblastic Leukemia (AML-M7) to Acute Lymphoblastic Leukemia (ALL) and Back Again: A Case Report

Shoko Kobayashi, Masanao Teramura, Hideaki Mizoguchi and Junji Tanaka

A 39-year-old female patient was diagnosed with immune thrombocytopenia in 1981 and treated with prednisolone. In 1997, she was diagnosed with acute megakaryoblastic leukemia (AML-M7), for which she received chemotherapy and achieved partial remission. She received supportive therapy, including blood transfusion. One year later, she was diagnosed with acute lymphoblastic leukemia (ALL-L2). She achieved complete remission (CR) with chemotherapy, but during consolidation therapy, L3 type ALL relapsed. She was given ALL-L3 targeting chemotherapy and achieved CR. However, several months later, AML-M7 relapsed. This is a very rare case of leukemia lineage switch that has not been reported previously.