title: Isolated gut relapse presenting as chronic diarrhea during maintenance therapy for acute lymphoblastic leukemia.
abstract: Ten-year-old boy with acute lymphoblastic leukemia (ALL)-T cell subtype was on MRC UKALL 2003-based chemotherapy. Bone marrow attained remission after induction. After 8 months into maintenance, he presented with chronic diarrhea and weight loss. Search for infective and malabsorptive etiology was unrewarding. Infiltration with leukemic cells was seen in the lamina propria on mucosal biopsies of duodenum and colon. Marrow was in remission. Isolated gut relapse is exceedingly rare. It should be considered in the etiology of chronic diarrhea in patients with ALL, after common causes are excluded.
authors.affiliation: Division of Pediatric Hematology and Oncology, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Anuj
authors.initials: A
authors.lastname: Bhatti
authors.forename: Deepak
authors.initials: D
authors.lastname: Bansal
authors.forename: Rakesh K
authors.initials: RK
authors.lastname: Vashishta
authors.forename: Sadhna B
authors.initials: SB
authors.lastname: Lal
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002648:Child; D002908:Chronic Disease; D003937:Diagnosis, Differential; D003967:Diarrhea / Q000209:etiology*; D017809:Fatal Outcome; D006801:Humans; D007414:Intestinal Neoplasms / Q000473:pathology*; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy / Q000473:pathology*; D012008:Recurrence