F-18 FDG PET findings of Takayasu arteritis before and after immunosuppressive therapy.

A 73-year-old woman with a 3-month history of fever of unknown origin underwent F-18 FDG positron emission tomography (PET). The serum C-reactive protein was 9.62 mg/dL. Her systolic blood pressure was 120 and 96 mm Hg in the right and left arms, respectively. FDG PET images demonstrated intense FDG uptake in the aorta and bilateral subclavian and brachiocephalic arteries consistent with Takayasu arteritis. After 6 weeks of immunosuppressive therapy, a follow-up PET scan showed disappearance of the large vessel uptake of FDG. She was asymptomatic, with a normal C-reactive protein (0.06 mg/dL).

[Limited but potential efficacy by graft-versus-leukemia (GVL) for Pro T-ALL].

We present a 22-year-old male diagnosed with pro T-acute lymphoblastic leukemia (ALL). His laboratory test showed 181,900/microL of WBC complicated with lymphoadenopathy, pleural effusion, pericardial effusion and hepatosplenomegaly at the onset. Flow cytometry analysis of the leukemic cells showed cCD3+, CD7+, CD2+, CD1a-, CD3-, CD5-, CD4-, CD8-, CD34+, and HLA-DR+ as a pro T-cell phenotype. The patient was treated with induction therapy followed by 3 courses of consolidation therapy and achieved his first complete remission. He underwent up-front stem cell transplantation (SCT) from an HLA-full matched sibling, with early relapse just before transplantation. The conditioning regimen consisted of fludarabine (100 mg/m2) and melphalan (180 mg/m2). He relapsed with an extramedullary mass (gingival, testis, and femoral muscles) 1 year after transplantation. Since bone marrow involvement was not apparent, he received involved field radiation therapy (25.2 Gy/14 frequencies) in each mass. Six months after extramedullary relapse, bone marrow relapse occurred, and the patient died of sepsis due to Pseudomonas aeruginosa during re-induction therapies. Based on the immature T cell phenotype frequently with myeloid markers, a graft-versus- leukemic effect might be expected after allogeneic SCT for Pro T-ALL and a positive indication of SCT for this disease should be considered.