Double leukemias simultaneously showing lymphoblastic leukemia of the bone marrow and monocytic leukemia of the central nervous system.
A rare case of different leukemias simultaneously occurring in the bone marrow (BM) and the central nervous system (CNS) was encountered. A 4-year-old girl was diagnosed with acute lymphoblastic leukemia and achieved a complete remission with chemotherapy. Two years after diagnosis, she was found to have acute monocytic leukemia at first relapse in the BM. One month after the second course of induction therapy, lymphoblastic leukemia in the BM and monocytic leukemia in the CNS were found simultaneously. Chromosomal analysis of leukemia cells in the BM and CNS showed distinct results. The mechanism of double leukemias occurring was obscure, although a lineage switch, therapy-related, or de novo leukemia could be considered as possibilities. Double leukemias should be kept in mind when leukemias relapse in several sites.
Division of Pediatrics, Department of Homeostatic Regulation and Development, Niigata University Graduate School of Medical and Dental Science, Niigata, Japan.
Yukie
Y
Ikarashi
Toshio
T
Kakihara
Chihaya
C
Imai
Atsushi
A
Tanaka
Akihiro
A
Watanabe
Makoto
M
Uchiyama
D014408:Biomarkers, Tumor / Q000032:analysis; D019046:Bone Marrow Neoplasms / Q000097:blood / Q000188:drug therapy / Q000235:genetics / Q000473:pathology*; D016543:Central Nervous System Neoplasms / Q000097:blood / Q000188:drug therapy / Q000235:genetics / Q000473:pathology*; D002675:Child, Preschool; D005260:Female; D006651:Histocytochemistry; D006801:Humans; D007621:Karyotyping; D007945:Leukemia, Lymphoid / Q000097:blood / Q000188:drug therapy / Q000235:genetics / Q000473:pathology*; D007948:Leukemia, Monocytic, Acute / Q000097:blood / Q000188:drug therapy / Q000235:genetics / Q000473:pathology*; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D012074:Remission Induction
D014408:Biomarkers, Tumor