Simultaneous development of bilateral retrobulbar and intradural spinal masses following donor lymphocyte infusions for acute lymphoblastic leukemia relapsing after bone marrow transplantation |
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Authors: | Jaing Tang-Her Wang Huei-Shyong Tseng Chen-Kan Hsueh Chuen Wang Chao-Jan Tsai Yueh-Ju |
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Affiliation: | Division of Hematology and Oncology, Department of Pediatrics, Chang Gung Children's Hospital, Taoyuan, Taiwan. jaing001@cgmh.org.tw |
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Abstract: | The authors describe a 6-year-old boy with acute lymphoblastic leukemia in relapse after bone marrow transplantation. Complete remission was obtained after reinduction chemotherapy followed by donor lymphocyte infusions. Ten months later, right-sided proptosis and exotropia developed, with back pain and leg paralysis. Computed tomography revealed bilateral orbital masses. Magnetic resonance imaging demonstrated abnormal signal intensity in the T4-6 vertebral bodies and an intradural mass on the left posterior side of the spinal canal. Although bone marrow aspiration was negative, orbital mass biopsies revealed CD10-positive lymphoblasts. Chimerism analysis of bone marrow and peripheral blood showed full donor alleles. Local radiotherapy and chemotherapy resulted in neurologic improvement. |
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