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A Unique Case of Concomitant T‐Prolymphocytic Leukemia and B‐Cell Acute Lymphoblastic Leukemia

Year: 2026

Type: article

Abstract: ABSTRACT T‐prolymphocytic leukemia (T‐PLL) is a rare lymphoid malignancy with a poor prognosis. B‐cell acute lymphoblastic leukemia (B‐ALL) also confers a poor prognosis, especially in patients with high‐risk features without an option for transplant. Here, we present a case of a patient with T‐PLL initially treated with multi‐agent chemotherapy who then developed B‐ALL, the management strategies, and possible pathogenesis of two concurrent rare malignancies. One proposed mechanism for the development of both hematologic malignancies in this patient is the acquisition of a KMT2A rearrangement, raising the possibility of clonal evolution resulting in therapy‐related or secondary leukemia. Another explanation is the presence of a common clonal stem cell progenitor harboring a JAK3 mutation.

Source: eJHaem

DOI: 10.1002/jha2.70252