RESUMO
Contemporary protocols ensure high-remission rate and long-term free survival in children with acute lymphoblastic leukemia (ALL), but small percentage of patients is still incurable. Molecular genetic methods helped to establish submicroscopic classification as well as minimal residual disease follow-up, considered to be responsible for relapse. Our study enrolled 70 pediatric patients with de novo ALL, analyzed using reverse transcriptase-polymerase chain reaction for the presence of four major risk-stratifying translocations (BCR/ABL, MLL/AF4, TEL/AML1, and E2A/PBX1). Bone marrow samples were collected at diagnosis, at the end of induction phase, and after intensive chemotherapy with the aim to establish the correlation between chromosomal aberration, clinical features, and treatment response. Presenting the results of this study, we offer another evidence of variable incidence and clinical characteristics of ALL subtypes.
Assuntos
Proteínas de Neoplasias/genética , Proteínas de Fusão Oncogênica/genética , Leucemia-Linfoma Linfoblástico de Células Precursoras/diagnóstico , Leucemia-Linfoma Linfoblástico de Células Precursoras/genética , Adolescente , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Lactente , Masculino , Proteínas de Neoplasias/classificação , Proteínas de Fusão Oncogênica/classificação , Leucemia-Linfoma Linfoblástico de Células Precursoras/patologia , Translocação GenéticaRESUMO
INTRODUCTION: The prognosis of hepatoblastoma has changed since effective adjuvant chemotherapy had been introduced in 1980's. There is a general agreement that complete resection is the cornerstone of treatment for children with hepapatoblastoma and the only way for eventual cure. CASE REPORT: We describe a boy with relapsed hepatoblastoma presenting with elevated -fetoprotein (AFP) and no visible tumor by ultrasound and computed tomography (CT). The relapse was treated with chemotherapy. Second relapse occurred shortly after therapy was completed, but this time we waited for tumor mass to appear. Combined surgery and chemotherapy resulted in remission status with 48 months of follow up. CONCLUSION: Hepatoblastoma relapse without evidence of tumor is not unusual but its treatment remains controversial. Radiological investigations should be repeated until site of relapse is identified. Based on our experience it seems of no benefit to treat isolated elevation of AFP.