| A case of acute lymphoblastic leukemia complicating neuroblastoma in remission. |
|
Dong Woo Son, Bum Soo Park, Jun Jae Kim, Hong Hoe Koo, Hee Young Shin, Hyo Seop Ahn |
|
Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea |
| 신경아세포종 완해 후 발생한 급성 림프구성 백혈병 1례 |
|
손동우, 박범수, 김준재, 구홍희, 신희영, 안효섭 |
|
서울대학교 의과대학 소아과학교실 |
|
Received: 28 September 1990 • Accepted: 9 November 1990 |
|
|
| Abstract |
|
As childhood cancer survivors are now increasing in number owing to the improvements in
diagnosis, staging, and treatment, concerns have been raised regarding the quality of survival of these
patients. One of the limitation to quality and length of survival has been the development of second
malignant neoplasm (SMN). In Korea, only one case of SMN has been reported. However, one can
expect that the number of SMN will increase along with the increasing number of childhood cancer
survivors. The pathogenesis of SMN is possibly related with treatment factors. SMN’s are so
refractory to treatment that the prognosis of the patients are guarded.
SMN occurring after neuroblastoma is extremely rare event, especially when the SMN is acute
leukemia. We have experienced a case of acute lymphoblastic leukemia (L3) in treated neuroblas-
toma.
The patient, a 4-year-6-month-old boy was the product of the non-related parents. When his age
was 100 days, 2 〜 3cm sized mass was first noted on his right thigh posteriorly. At the age of 14
months, excisional boipsy of the mass revealed malignancy. At that time, left adrenal mass was
found. After the left adrenalectomy and biopsy, he was diagnosed as neuroblastoma. He was managed
with vincristine and cyclophosphamide for 10 weeks and 6 months respectively. Total cumulative
doses of the durgs were ; vincristine 7mg (15mg/M2), cyclophosphamide 4,325mg (8,650mg/M2). The
evidence of residual disease was absent. In October 1988, 31 months after completion of chemother-
apy, he was presented to us with a 12-day history of pallor and petechiae. Liver was palpable 5FB
under the right subcostal margin. Spleen was palpable 8FB. Initial CBC were ; Hb 6.8gm/dl, WBC
37,800/mm3, platelet 28,000/mm3. With bone marrow aspiration and biopsy, he was diagnosed as
acute lymphoblastic leukemia (B-cell type). Chemotherapy with D-COMP regimen was done. After the
completion of induction chemotherapy, remission was achieved. But in December 1989, peripheral
lymphoblasts were seen and bone metastasis was confirmed by bone scan and bone x-ray. Further
treatment was refused by his parents. He expired in December 1989,14 months after the diagnosis of
SMN. |
| Key Words:
Second Malignant Neoplasm, Neuroblastoma, Acute Lymphoblastic Leukemia |
|
PDF Links
Download Citation
