Simultaneous development of bilateral retrobulbar and intradural spinal masses following donor lymphocyte infusions for acute lymphoblastic leukemia relapsing after bone marrow transplantation.
The authors describe a 6-year-old boy with acute lymphoblastic leukemia in relapse after bone marrow transplantation. Complete remission was obtained after reinduction chemotherapy followed by donor lymphocyte infusions. Ten months later, right-sided proptosis and exotropia developed, with back pain and leg paralysis. Computed tomography revealed bilateral orbital masses. Magnetic resonance imaging demonstrated abnormal signal intensity in the T4-6 vertebral bodies and an intradural mass on the left posterior side of the spinal canal. Although bone marrow aspiration was negative, orbital mass biopsies revealed CD10-positive lymphoblasts. Chimerism analysis of bone marrow and peripheral blood showed full donor alleles. Local radiotherapy and chemotherapy resulted in neurologic improvement.
Jaing
Tang-Her
TH
Division of Hematology and Oncology, Department of Pediatrics, Chang Gung Children's Hospital, Taoyuan, Taiwan. jaing001@cgmh.org.tw
Wang
Huei-Shyong
HS
Tseng
Chen-Kan
CK
Hsueh
Chuen
C
Wang
Chao-Jan
CJ
Tsai
Yueh-Ju
YJ
D001853:Bone Marrow / Q000473:pathology; D016026:Bone Marrow Transplantation; D002648:Child; D006801:Humans; D017710:Lymphocyte Transfusion; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D009918:Orbital Neoplasms / Q000473:pathology* / Q000503:physiopathology; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000473:pathology* / Q000503:physiopathology / Q000628:therapy; D013125:Spinal Neoplasms / Q000473:pathology* / Q000503:physiopathology