Controversial Flow Cytometry Monitoring of a Relapse Case of Pediatric T Cell Acute Lymphoblastic Leukemia: A Case Report

• Published in: Frontiers in medicine Vol. 9; p. 858809
• Main Authors: Popa, Delia Codruţa, Şerbănică, Andreea, Obrisca, Radu, Şerbănică, Ionut, Radu, Letiţia, Jercan, Cristina, Marcu, Andra, Bica, Ana, Asan, Minodora, Petran, Mădălina, Dragomir, Mihaela, Jardan, Cerasela, Ţică, Valeria, Gheorghe, Anca, Stoian, Irina, Coriu, Daniel, Coliţă, Anca, Coliţă, Andrei
• Format: Journal Article
• Language: English
• Published: Switzerland Frontiers Media S.A 22.03.2022
• Subjects: allotransplant; children; leukemia; Medicine; relapse; stem cell; T cell; leukemia; allotransplant; stem cell; children; relapse; T cell
• ISSN: 2296-858X; 2296-858X
• DOI: 10.3389/fmed.2022.858809

Acute lymphoblastic leukemia (ALL) is the most frequent childhood cancer, with 80-85% represented by B cell ALL and only 15% by T cell ALL. T Cell ALL (T-ALL) carries a more reserved prognosis compared to B Cell ALL (B-ALL) with regard to response to treatment, risk of relapse, and overall survival. Progress made in current monitoring protocols such as flow cytometry immunophenotyping (FCM) and by PCR-based amplification of antigen-receptor genes led to improved management of patients with ALL and superior rates of survival. Nevertheless, challenges remain in some clinical cases. This manuscript describes a unique case of T-ALL and raises awareness of such clinical challenges. The article presents an overview of the flow cytometry immunophenotyping at diagnosis and during treatment of a pediatric patient with T-ALL from Fundeni Clinical Institute. In this case, in spite of various therapeutic measures such as first-line chemotherapy for high risk group, salvage chemotherapy (FLAG), conditioning regimen (FLU-BU-TT-ATG), and stem cell transplant, a chemoresistance clone continued to be present.