Acute T-lymphoblastic leukemia relapsed with the character of myeloid/natural killer cell precursor phenotype: a case report.

The leukemic lymphoblasts of a patient expressed CD7, CD13, CD33, CD34, HLA-DR and cytoplasmic CD3varepsilon. He was diagnosed with acute lymphoblastic leukemia (ALL), and successfully treated with a conventional chemotherapy for ALL. The disease relapsed three times, and the character of the cells gradually altered, i.e. CD56 expression increased and CD13, CD7 and cCD3 epsilon decreased. The phenotype of the relapsed ALL was, therefore, compatible with myeloid/natural killer cell precursor acute leukemia (M/NK-AL). Some of M/NK-AL may be closely related with T/myeloid-biphenotypic pro-T blasts, and both types of acute leukemia may develop a tendency to express myeloid antigens, and they may belong to the category of immature T lymphoid precursors.