Cardiac Relapse of Acute Lymphoblastic Leukemia Following Hematopoietic Stem Cell Transplantation: A Case Report and Review of Literature

Cancers

Chandra Srinivasan¹  Anna Franklin²  Bhiong Zhao³  Demetrios Petropoulos⁴  Kris M. Mahadeo⁴  Sajad J. Khazal⁴  Priti Tewari⁴  Dristhi Ragoonanan⁴  Irtiza N. Sheikh⁵ 

[1]Cardiac Center, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA

[2]Center for Cancer and Blood Disorders, Children’s Hospital Colorado, Aurora, CO 80045, USA

[3]Department of Pathology and Laboratory Medicine, The University of Texas Health Science Center McGovern Medical School, Houston, TX 77054, USA

[4]Department of Pediatrics, Pediatric Stem Cell Transplantation and Cellular Therapy, CARTOX Program, University of Texas at MD Anderson Cancer Center, Houston, TX 77030, USA

[5]Division of Pediatrics and Patient Care, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA

关键词: relapse/refractory leukemia;    extramedullary disease;    stem cell transplantation;    CAR T-cell therapy;    cardiac relapse;    pediatrics;   

DOI  :  10.3390/cancers13225814

来源: DOAJ

【 摘 要 】

Isolated extramedullary relapse of acute lymphoblastic leukemia (ALL) occurs in soft tissues and various organs outside the testis and central nervous system. Treatments such as hematopoietic stem cell transplantation and more novel modalities such as immunotherapy have eradicated ALL at extramedullary sites. In some instances, survival times for relapsed ALL at these sites are longer than those for relapsed disease involving only the bone marrow. Isolated relapse of ALL in the myocardium is rare, especially in children, making diagnosis and treatment of it difficult. More recent treatment options such as chimeric antigen receptor T-cell therapy carry a high risk of cytokine release syndrome and associated risk of worsening cardiac function. Herein we present the case of an 11-year-old boy who presented with relapsed symptomatic B-cell ALL in the myocardium following allogeneic hematopoietic stem cell transplantation. This is an unusual presentation of relapsed ALL and this case demonstrates the associated challenges in its diagnosis and treatment. The case report is followed by a literature review of the advances in treatment of pediatric leukemia and their application to extramedullary relapse of this disease in particular.

【 授权许可】

Unknown