Muhammad Nadeem, Nayab Khan.
Crossroads in Acute Leukemia: Mixed Lineage APL - ETO Acute Myeloid Leukemia.
J Rawal Med Coll Jan ;19(3):280-2.

Acute Myeloid Leukemia (AML) is one of the two major forms of acute leukemia. It accounts for about 25% of all adult leukemias diagnosed in the west. It is primariy a disease of late adulthood with mean age of diagnosis 65 years. Diagnosis of AML in children and young adults is fairly uncommon comprising only 15- 20% of all acute leukemia in children less than 15 years of age. 1 AML has been classified using the French-AmericanBritish (FAB) classification into various subtypes (M1- M6) depending upon certain morphological characteristics.2 This has further been elaborated by the WHO based on the distinct cellular appearance, immunophenotypic profile and associated cytogenetic mutations.3 Not only do these help in identification of AML type, but also serve as a guide to treatment responsiveness and prognosis. However, approximately 45% of AML patients have normal cytogenetics and are the most diverse group with regards to treatment response and prognosis. Within this sub group other gene mutations have been described that confer better or worse prognosis.4 Treatment options traditionally consist of the standard ‘3+7’ regimen for AML other than M3 and protocols including oral all trans-retinoic acid (ATRA) for AMLM3. 5,6We report a case of 38 years old male who was diagnosed as a case of mixed lineage APL – ETO acute myeloid leukemia and was managed merging the treatment strategies for FAB AML - M2 and FAB AML - M3. He achieved complete hematological and molecular remission

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