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Cătană AC, Vlădoiu MG, Sandu M, Olteanu A, Mocanu L, Mihai E, Teodoru M, Matei C, Zahu R, Varady Z, Mondoc L, Noor C, Moicean A, Mera G. A Unique Case of Extramedullary Relapse in Acute Lymphoblastic Leukemia: Testicular to Ocular, Cardiac, and Colonic Involvement and the Role of Sperm Phenotyping in Diagnosis-Case Report and Literature Review. J Clin Med 2025; 14:405. [PMID: 39860409 PMCID: PMC11766149 DOI: 10.3390/jcm14020405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2024] [Revised: 12/30/2024] [Accepted: 01/07/2025] [Indexed: 01/27/2025] Open
Abstract
Acute lymphoblastic leukemia (ALL) is a malignant condition of lymphoid progenitor cells that primarily affects the pediatric population, but also adults. The 5-year survival rate is 90% in children and approximately 40% in adults, with survival increasing through the use of peripheral stem cell allotransplantation (SCT). The relapse rate after stem cell transplantation (SCT) in adult acute lymphoblastic leukemia (ALL) patients ranges from 35% to 45%, making relapse a major cause of death in this population. Background: We present an atypical case of late testicular involvement in ALL in a 50-year-old man diagnosed with ALL pro-T in remission post-chemotherapy (GMALL 2003 protocol) and allogeneic stem cell transplantation (alloSCT) from a related donor. Methods: This case describes a 50-year-old male with ALL pro-T who experienced three rare extramedullary relapses post-chemotherapy and alloSCT. Five years after remission, he had a unilateral testicular relapse confirmed by immunophenotyping of spermatic fluid. Results: Despite no bone marrow involvement, he was treated with chemotherapy, intrathecal therapy, and bilateral testicular radiotherapy. He later relapsed in the orbit, controlled by radiotherapy, followed by a third relapse in the heart and colon. Conclusions: This case highlights the unusual sites and consecutive nature of extramedullary relapses in adult ALL.
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Affiliation(s)
- Alina Camelia Cătană
- County Clinical Emergency Hospital Sibiu, 550245 Sibiu, Romania; (M.S.); (A.O.); (L.M.); (E.M.); (M.T.); (L.M.); (C.N.); (G.M.)
- Faculty of Medicine Sibiu, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania;
| | - Maria-Gabriela Vlădoiu
- County Clinical Emergency Hospital Sibiu, 550245 Sibiu, Romania; (M.S.); (A.O.); (L.M.); (E.M.); (M.T.); (L.M.); (C.N.); (G.M.)
- Faculty of Medicine Sibiu, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania;
| | - Mariana Sandu
- County Clinical Emergency Hospital Sibiu, 550245 Sibiu, Romania; (M.S.); (A.O.); (L.M.); (E.M.); (M.T.); (L.M.); (C.N.); (G.M.)
| | - Ariela Olteanu
- County Clinical Emergency Hospital Sibiu, 550245 Sibiu, Romania; (M.S.); (A.O.); (L.M.); (E.M.); (M.T.); (L.M.); (C.N.); (G.M.)
| | - Liliana Mocanu
- County Clinical Emergency Hospital Sibiu, 550245 Sibiu, Romania; (M.S.); (A.O.); (L.M.); (E.M.); (M.T.); (L.M.); (C.N.); (G.M.)
| | - Elena Mihai
- County Clinical Emergency Hospital Sibiu, 550245 Sibiu, Romania; (M.S.); (A.O.); (L.M.); (E.M.); (M.T.); (L.M.); (C.N.); (G.M.)
| | - Minodora Teodoru
- County Clinical Emergency Hospital Sibiu, 550245 Sibiu, Romania; (M.S.); (A.O.); (L.M.); (E.M.); (M.T.); (L.M.); (C.N.); (G.M.)
- Faculty of Medicine Sibiu, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania;
| | - Claudiu Matei
- Faculty of Medicine Sibiu, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania;
- Medlife Polisano Hospital, 550172 Sibiu, Romania
| | - Renata Zahu
- Amethyst Radiotherapy Center, 407280 Cluj Napoca, Romania;
| | - Zsofia Varady
- Fundeni Clinical Insitute, 022328 Bucuresti, Romania;
| | - Lidia Mondoc
- County Clinical Emergency Hospital Sibiu, 550245 Sibiu, Romania; (M.S.); (A.O.); (L.M.); (E.M.); (M.T.); (L.M.); (C.N.); (G.M.)
- Faculty of Medicine Sibiu, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania;
| | - Cristina Noor
- County Clinical Emergency Hospital Sibiu, 550245 Sibiu, Romania; (M.S.); (A.O.); (L.M.); (E.M.); (M.T.); (L.M.); (C.N.); (G.M.)
- Faculty of Medicine Sibiu, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania;
| | | | - Geanina Mera
- County Clinical Emergency Hospital Sibiu, 550245 Sibiu, Romania; (M.S.); (A.O.); (L.M.); (E.M.); (M.T.); (L.M.); (C.N.); (G.M.)
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A Multicenter Cohort Study on Children Suffering from Acute Lymphoblastic Leukemia: Effects of Obesity on Mortality. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:4880151. [PMID: 35836926 PMCID: PMC9276514 DOI: 10.1155/2022/4880151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 06/13/2022] [Indexed: 11/18/2022]
Abstract
Background Overweight and obesity have been reported in specific patients and disease survivors compared to other types of childhood cancer. This study is aimed at determining the effect of children's obesity on the mortality of acute lymphoblastic leukemia. Method Children admitted to Inner Mongolia International Mongolian Hospital from 1 January 2017 to 31 December 2020 participated in this study. 1070 children were analyzed. A multi-middle-class poll was conducted. All children under the age of 15 were followed up within 24 months of diagnosis. Overweight and obesity are identified according to the World Health Organization and the Centers for Disease Control and Prevention. Premature death and reoccurrence of emergencies are the main consequences. Results The initial ethical rate for the first 24 months of testing was 19.9% (NS 213). The lowest cancer survival rate (DFS) was childhood obesity (73%) (24 months), compared with average weight (81%). Diagnosis of overweight/obesity is a predictor of early death (WHO: HR = 1.4, 95% CI: 1.0-2.0; CDC: HR = 1.6, 95% CI: 1.1-2.3). However, there was no association between overweight and obesity (WHO: HR = 1.5, 95% effective interval: 0.9-2.5; CDC: human resources = 1.0, 95% effective interval: 0.6-1.6) and obesity (WHO: HR = 1.5, 95% effective interval: 0.7-3.2; CDC: HR = 1.4, 95% effective interval: 0.9-2.3). Early recurrence was observed. Conclusion Overweight and obese people belong to the subclass with a high risk of death in the treatment of leukemia.
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He J, Zhang Y, Wang Z, Liu J. Pericardial involvement in a common B-cell acute lymphoblastic leukemia patient. Int J Lab Hematol 2022; 44:1003-1004. [PMID: 35644947 DOI: 10.1111/ijlh.13904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 05/17/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Jing He
- College of Medical Technology, Zhejiang Chinese Medical University, Hangzhou, China.,Laboratory Medicine Center, Department of Clinical Laboratory, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China
| | - Yushan Zhang
- Department of Orthopedics, Xinchang Hospital Affiliated to Wenzhou Medical University, Xinchang, China
| | - Zhenni Wang
- Laboratory Medicine Center, Department of Clinical Laboratory, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China
| | - Jinlin Liu
- Laboratory Medicine Center, Department of Clinical Laboratory, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China
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Handgretinger R. Editorial to: Advance in the Treatment of Pediatric Leukemia. J Clin Med 2022; 11:jcm11092361. [PMID: 35566486 PMCID: PMC9102433 DOI: 10.3390/jcm11092361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 04/19/2022] [Indexed: 02/01/2023] Open
Affiliation(s)
- Rupert Handgretinger
- Department I–General Pediatrics, Hematology/Oncology, Children’s Hospital, University Hospital Tübingen, 72076 Tübingen, Germany;
- Abu Dhabi Stem Cell Center, Abu Dhabi, United Arab Emirates
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