Objective:

To report a rare case of Philadelphia chromosome-positive mixed-phenotype acute leukemia (Ph+ MPAL) occurring concurrently with active Epstein-Barr virus (EBV) viremia in a kidney transplant recipient.

Approach:

• Therapeutic Strategy: A tailored therapeutic strategy was implemented, combining olverembatinib with dexamethasone, lisaftoclax, and azacitidine for leukemia treatment, alongside B-cell–depleting therapy with rituximab for EBV viremia.

Key Findings:

• The patient achieved hematologic remission and clearance of EBV viremia after treatment.
• This case represents the first reported instance of Ph+ MPAL co-occurring with active EBV infection in a kidney transplant patient.

Interpretation:

Limitations:

• The rarity of the case limits generalizability.
• Further studies are needed to establish standardized treatment protocols for similar cases.

Conclusion: