title: Unusual sites of relapse in pre-B acute lymphoblastic leukemia.
abstract: Relapses of acute lymphoblastic leukemia (ALL) in unusual sites can be challenging to diagnose. We present unusual relapses occurring in children with ALL treated in a single institution over a 22-year period. Of 172 relapses, 9 (5.2%) were at unusual sites (nonmarrow, testes, central nervous system). The most common site of relapse was ocular (66%). The median symptom-to-diagnosis interval was 20 days. Two of 9 children attained second remission. A possibility of relapse should be considered when evaluating unusual symptoms in a child with underlying ALL.
authors.affiliation: *Pediatric Hematology Oncology Unit, Department of Pediatrics, Advanced Pediatric Centre Departments of †Ophthalmology ‡Cytology & Gynaecological Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Richa
authors.initials: R
authors.lastname: Jain
authors.forename: Amita
authors.initials: A
authors.lastname: Trehan
authors.forename: Ramandeep
authors.initials: R
authors.lastname: Singh
authors.forename: Radhika
authors.initials: R
authors.lastname: Srinivasan
authors.forename: Mangat
authors.initials: M
authors.lastname: Dogra
authors.forename: Deepak
authors.initials: D
authors.lastname: Bansal
authors.forename: Ram K
authors.initials: RK
authors.lastname: Marwaha
mesh_terms: D002490:Central Nervous System / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D005123:Eye / Q000473:pathology*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D017254:Leukemic Infiltration; D008297:Male; D015452:Precursor B-Cell Lymphoblastic Leukemia-Lymphoma / Q000473:pathology* / Q000628:therapy*; D012008:Recurrence; D012074:Remission Induction; D013737:Testis / Q000473:pathology*