Relapse of T-cell all after stem cell transplant presenting as hypertrophic cardiomyopathy: the value of non-invasive diagnostic imaging in detecting cardiac leukemia.
We describe a 14-year-old female with acute lymphoblastic leukemia (ALL) with a mediastinal mass at diagnosis who developed hypertrophic cardiomyopathy (HC) after stem cell transplantation (SCT). During refractory relapse after SCT using bone marrow from her HLA-matched sibling, she underwent whole thorax irradiation because of pleural effusion and a recurrent mediastinal mass. After a second SCT using peripheral blood from the same donor, she developed HC suspected to be related to tacrolimus. However, isolated cardiac relapse was finally diagnosed by several non-invasive imaging techniques. Cardiac irradiation resolved her cardiac failure, though she eventually developed progressive and fatal hematological disease.
Hori
Tsukasa
T
Department of Pediatrics, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, Japan. thori@sapmed.ac.jp
Suzuki
Nobuhiro
N
Mizue
Nobuo
N
Hatakeyama
Naoki
N
Takamuro
Motoki
M
Tsutsumi
Hiroyuki
H
D000293:Adolescent; D002312:Cardiomyopathy, Hypertrophic / Q000209:etiology*; D003952:Diagnostic Imaging; D005260:Female; D006801:Humans; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D017254:Leukemic Infiltration / Q000000981:diagnostic imaging / Q000473:pathology; D008279:Magnetic Resonance Imaging; D009206:Myocardium / Q000473:pathology*; D011877:Radionuclide Imaging; D012008:Recurrence; D033581:Stem Cell Transplantation; D014057:Tomography, X-Ray Computed