ABSTRACT
Childhood anaplastic large cell lymphoma (ALCL) accounts for approx. 10-30% of cases of non-Hodgkin lymphoma, and the ALCL99 study reported 60-75 disease-free survival; however, a relatively high relapse rate was observed (25-30% ). We report 2 patients with Stage III ALCL who relapsed 6-18 months after the end of ALCL99 chemotherapy. A retrospective molecular analysis identified the nucleophosmin (NPM)-anaplastic lymphoma kinase (ALK) fusion gene in the first diagnostic bone marrow samples taken from both patients. However, antibodies against the ALK protein appeared to be relatively low in the serum of both patients (×100 and ×750). An increase in chemotherapy intensity may be beneficial if Stage III ALCL patients are shown to be NPM-ALK chimera-positive in the first diagnostic bone marrow sample.
Subject(s)
Lymphoma, Large-Cell, Anaplastic/pathology , Anaplastic Lymphoma Kinase , Antibodies, Neoplasm/blood , Antineoplastic Agents/therapeutic use , Child , Humans , Lymphoma, Large-Cell, Anaplastic/drug therapy , Receptor Protein-Tyrosine Kinases/immunology , RecurrenceABSTRACT
Juvenile myelomonocytic leukemia (JMML) appears to be a life-threatening disease and showed poor prognosis even after hematopoietic stem cell transplantation (HSCT) because of high relapse rate. On the other hand, recent molecular analysis revealed the heterogeneity of JMML. Here we report that two JMML patients survived >20 years without HSCT and both patients had uniparental disomy of 11q23 where CBL is located without the phenomenon found in neither Noonan syndrome nor Noonan syndrome-like disorder. We think that some JMML patients with CBL mutation might show the good prognosis in later life after remission of JMML.
Subject(s)
Germ-Line Mutation , Leukemia, Myelomonocytic, Juvenile/diagnosis , Leukemia, Myelomonocytic, Juvenile/genetics , Proto-Oncogene Proteins c-cbl/genetics , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , DNA Mutational Analysis , Female , Follow-Up Studies , Humans , Infant , Leukemia, Myelomonocytic, Juvenile/drug therapy , Loss of Heterozygosity , Male , Phenotype , Polymorphism, Single Nucleotide , Treatment Outcome , Uniparental DisomyABSTRACT
The treatment of patients with congenital leukemia is difficult and often results in a poor prognosis. We present here the case of a female child with congenital acute myeloid leukemia (AML) with t(8 ; 16) (p11 ; p13) who received chemotherapy and survived for more than 10 years without relapse. A novel MOZ-CBP chimera was found in her diagnostic sample. Although adult AML patients with MOZ-CBP have mainly been reported as having therapy-related AML and showed poor prognoses, the present case supports the idea that AML with MOZ-CBP in the pediatric population might show better prognoses.
Subject(s)
Leukemia, Myeloid, Acute/congenital , Oncogene Proteins, Fusion/genetics , Chromosomes, Human, Pair 16 , Chromosomes, Human, Pair 8 , Female , Gene Rearrangement , Humans , Infant, Newborn , Leukemia, Myeloid, Acute/genetics , RNA, Neoplasm/analysis , Sequence Analysis, RNA , SurvivorsABSTRACT
Clonal cytogenetic abnormalities (CCA) in Philadelphia chromosome (Ph)-negative cells have been reported in a small population of adult chronic myelogenous leukemia (CML) patients during the clinical course, but CCA in pediatric CML patients are rarely reported. We herein report the case of an 8-year-old boy from the onset of CML. Although he had relapse after unrelated bone marrow transplantation when 9 years old, he has since been in complete molecular response on imatinib mesylate treatment. Surprisingly, various CCA have been observed in this patient, including several reciprocal chromosomal translocations in Ph-negative cells for >12 years. Although dysplasia in the bone marrow cells was identified, no overt transformation to myelodysplastic syndrome or acute myeloid leukemia has been observed. The cause of the CCA remains unknown in this patient, and careful observation is required.
