Development of secondary anaplastic oligoastrocytoma after matched unrelated bone marrow transplantation in a child with acute myeloid leukemia.
The growing incidences of secondary malignancies in long-term survivors of childhood leukemia following allogeneic bone marrow transplantation (alloBMT) are increasingly being reported. Among the late complications of conventional myeloablative alloBMT, the occurrence of secondary malignant solid tumors is of major concern. Secondary malignant and benign brain tumors such as astrocytoma, meningioma and glioblastoma have been described in long-term survivors of conventional myeloablative alloBMT. Here we report a case of secondary anaplastic oligoastrocytoma that developed 7 years after matched unrelated alloBMT for relapsing childhood acute myeloid leukemia (AML) with CNS involvement. Although isolated CNS relapse of primary leukemia following alloBMT is not uncommon, it is important to identify and define potential risk factors that may lead to the development of secondary brain tumors in children who received high-dose chemotherapy and irradiation prior to alloBMT presenting with progressive neurological symptoms and to differentiate them from leukemia relapse with CNS involvement.
Panigrahi
Soumya
S
Department of Bone Marrow Transplantation, Hadassah University Hospital, Jerusalem, Israel. dsp@hotmail.com
Das
Mayukh
M
Stagler
Dalia
D
Konstantini
Shlomi
S
Gmori
Moshe
M
Slavin
Shimon
S
Nagler
Arnon
A
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D001215:Asparaginase / Q000008:administration & dosage / Q000009:adverse effects; D001254:Astrocytoma / Q000175:diagnosis / Q000209:etiology*; D016026:Bone Marrow Transplantation; D001932:Brain Neoplasms / Q000175:diagnosis / Q000209:etiology*; D002675:Child, Preschool; D003131:Combined Modality Therapy; D016371:Cranial Irradiation / Q000009:adverse effects*; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D003561:Cytarabine / Q000008:administration & dosage / Q000009:adverse effects; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D007278:Injections, Spinal; D007948:Leukemia, Monocytic, Acute / Q000150:complications / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D008297:Male; D009381:Neoplasms, Radiation-Induced / Q000175:diagnosis / Q000209:etiology*; D016609:Neoplasms, Second Primary / Q000175:diagnosis / Q000209:etiology*; D010296:Parietal Lobe; D012074:Remission Induction; D019172:Transplantation Conditioning / Q000009:adverse effects*; D014184:Transplantation, Homologous; D014916:Whole-Body Irradiation / Q000009:adverse effects
D007166:Immunosuppressive Agents; D003561:Cytarabine; D005047:Etoposide; D003520:Cyclophosphamide; D001215:Asparaginase