title: Successful treatment of acute leukemia with t(4;11) in an infant with congenital hypothyroidism.
abstract: We describe a case of acute leukemia with t(4;11) (q21;q23) in a 3-month-old girl suffering from congenital hypothyroidism. The blast cells were cytochemically and immunologically classifiable as acute lymphoblastic leukemia of an early B-cell lineage (HLA-DR +, B4 +, CALLA-). but we treated this patient with a protocol designed mainly for acute nonlymphocytic leukemia, employing Adriamycin, vincristine, and cytosine arabinoside. Although the prognosis of this type of leukemia is known to be extremely poor, our patient is currently alive and in continuous complete remission lasting 35 months to date. This case may demonstrate a potential alternative therapeutic strategy for acute leukemia with t(4;11) as well as clinical evidence for the mixed-lineage characteristics of this condition. However, the pathogenetic role of congenital hypothyroidism in the development of acute leukemia is still uncertain.
authors.affiliation: Division of Hematology and Oncology, Shizuoka Children's Hospital, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Tonouchi
authors.forename: J
authors.initials: J
authors.lastname: Mimaya
authors.forename: Y
authors.initials: Y
authors.lastname: Toyoda
authors.forename: Y
authors.initials: Y
authors.lastname: Kaneko
authors.forename: S
authors.initials: S
authors.lastname: Kawai
authors.forename: R
authors.initials: R
authors.lastname: Ueda
authors.forename: M
authors.initials: M
authors.lastname: Kondo
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002454:Cell Differentiation; D002880:Chromosomes, Human, Pair 11 / Q000648:ultrastructure*; D002894:Chromosomes, Human, Pair 4 / Q000648:ultrastructure*; D003409:Congenital Hypothyroidism; D016371:Cranial Irradiation; D003561:Cytarabine / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000150:complications*; D007223:Infant; D015122:Mercaptopurine / Q000008:administration & dosage; D008727:Methotrexate / Q000008:administration & dosage; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000145:classification / Q000150:complications / Q000235:genetics* / Q000628:therapy; D011239:Prednisolone / Q000008:administration & dosage; D012074:Remission Induction; D014178:Translocation, Genetic; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D003561:Cytarabine; D014750:Vincristine; D005047:Etoposide; D004317:Doxorubicin; D011239:Prednisolone; D015122:Mercaptopurine; D008727:Methotrexate