Unrelated Bone Marrow Transplantation for a Child with Acute Lymphoblastic Leukemia with Ventriculo-Peritoneal Shunt
An 8-year-old girl with acute lymphoblastic leukemia presented with complications of bacterial meningitis and hydrocephalus during induction therapy. Chemotherapy was applied for meningitis and ventriculo-peritoneal shunt operation was performed for hydrocephalus. Because bone marrow relapse was obs...
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| Published in | The Japanese Journal of Pediatric Hematology Vol. 13; no. 1; pp. 21 - 25 |
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| Main Authors | , , , , , , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
THE JAPANESE SOCIETY OF PEDIATRIC HEMATOLOGY/ONCOLOGY
1999
特定非営利活動法人 日本小児血液・がん学会 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0913-8706 1884-4723 |
| DOI | 10.11412/jjph1987.13.21 |
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| Abstract | An 8-year-old girl with acute lymphoblastic leukemia presented with complications of bacterial meningitis and hydrocephalus during induction therapy. Chemotherapy was applied for meningitis and ventriculo-peritoneal shunt operation was performed for hydrocephalus. Because bone marrow relapse was observed during these treatments, induction therapy was reapplied to obtain complete remission. After then, bone marrow transplantation (BMT) from an unrelated donor was performed. The conditioning regimen consisted of 12 Gy of total body irradiation and cyclophosphamide. Cyclosporin A and short-term methotrexate were used for GVHD prophylaxis. Engraftment was successful, and the patient has since maintained complete remission. The clinical course of this case may provide useful information for BMT of patients with complications of the central nervous system. |
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| AbstractList | An 8-year-old girl with acute lymphoblastic leukemia presented with complications of bacterial meningitis and hydrocephalus during induction therapy. Chemotherapy was applied for meningitis and ventriculo-peritoneal shunt operation was performed for hydrocephalus. Because bone marrow relapse was observed during these treatments, induction therapy was reapplied to obtain complete remission. After then, bone marrow transplantation (BMT) from an unrelated donor was performed. The conditioning regimen consisted of 12 Gy of total body irradiation and cyclophosphamide. Cyclosporin A and short-term methotrexate were used for GVHD prophylaxis. Engraftment was successful, and the patient has since maintained complete remission. The clinical course of this case may provide useful information for BMT of patients with complications of the central nervous system.
症例は8歳, 急性リンパ性白血病の女児.寛解導入中に細菌性髄膜炎および水頭症を合併した.髄膜炎に対しての化学療法と, 水頭症に対しての脳室-腹腔シャント術が行われた.その間に骨髄再発が認められたため, 再度の寛解導入が行われ完全寛解が得られた.その後非血縁者からの骨髄移植が施行された.前処置として12Gyの全身照射とサイクロホスファミドを用いた.シクロスポリンと短期メソトレキセートをGVHD予防として用いた.患児は良好な生着を得, 現在完全寛解継続中である.本症例の臨床経過は, 中枢神経系の合併症を有する症例への骨髄移植に関して, 有益な情報と思われる. An 8-year-old girl with acute lymphoblastic leukemia presented with complications of bacterial meningitis and hydrocephalus during induction therapy. Chemotherapy was applied for meningitis and ventriculo-peritoneal shunt operation was performed for hydrocephalus. Because bone marrow relapse was observed during these treatments, induction therapy was reapplied to obtain complete remission. After then, bone marrow transplantation (BMT) from an unrelated donor was performed. The conditioning regimen consisted of 12 Gy of total body irradiation and cyclophosphamide. Cyclosporin A and short-term methotrexate were used for GVHD prophylaxis. Engraftment was successful, and the patient has since maintained complete remission. The clinical course of this case may provide useful information for BMT of patients with complications of the central nervous system. |
| Author | NONAKA, Toshihide KATO, Kunihiko SUWABE, Shin-ichi KAKUDA, Harumi SATO, Takeyuki SAKAO, Eiko MIURA, Nobuyuki NOGUCHI, Yasushi OTA, Setsuo IGARASHI, Shunji NIIMI, Hiroo YAMAURA, Akira TERAOKA, Naoko |
| Author_FL | 三浦 信之 五十嵐 俊次 角田 治美 新美 仁男 寺岡 菜穂子 野口 靖 坂尾 詠子 山浦 晶 佐藤 武幸 野中 俊秀 太田 節雄 嘉藤 邦彦 諏訪部 信一 |
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| Author_xml | – sequence: 1 fullname: KAKUDA, Harumi organization: Department of Pediatrics, School of Medicine, Chiba University – sequence: 1 fullname: NOGUCHI, Yasushi organization: Department of Pediatrics, School of Medicine, Chiba University – sequence: 1 fullname: KATO, Kunihiko organization: Department of Neurosurgery, School of Medicine, Chiba University – sequence: 1 fullname: MIURA, Nobuyuki organization: Department of Pediatrics, School of Medicine, Chiba University – sequence: 1 fullname: SAKAO, Eiko organization: Department of Pediatrics, School of Medicine, Chiba University – sequence: 1 fullname: SATO, Takeyuki organization: Department of Pediatrics, School of Medicine, Chiba University – sequence: 1 fullname: YAMAURA, Akira organization: Department of Neurosurgery, School of Medicine, Chiba University – sequence: 1 fullname: IGARASHI, Shunji organization: Department of Pediatrics, School of Medicine, Chiba University – sequence: 1 fullname: OTA, Setsuo organization: Department of Pediatrics, School of Medicine, Chiba University – sequence: 1 fullname: SUWABE, Shin-ichi organization: Department of Pediatrics, School of Medicine, Chiba University – sequence: 1 fullname: NONAKA, Toshihide organization: Department of Pediatrics, School of Medicine, Chiba University – sequence: 1 fullname: NIIMI, Hiroo organization: Department of Pediatrics, School of Medicine, Chiba University – sequence: 1 fullname: TERAOKA, Naoko organization: Department of Pediatrics, School of Medicine, Chiba University |
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| References | 6) 土田嘉昭, 斎藤純夫, 本名敏郎, 他 : 白血病と外科的合併症-特にその外科治療について-.小児外科14 : 777-785, 1982 5) Rice MS, Cord-Udy C, Little KE, et al : Surgical complications in acute leukemia in childhood : A 20 year experience. Med Pediatr Oncol 20 : 32-37, 1992 4) Chanock SJ, Pizzo PA : Infectious complications of patients undergoing therapy for acute leukemia : Current status and future prospects. Semin Oncol 24 : 132-140, 1997 9) Slevin ML, Piall EM, Aherne GW, et al : Effect of dose and schedule on pharmacokinetics of high-dose cytosine arabinoside in plasma and cerebrospinal fluid. Clin Oncol 1 : 546-551, 1983 11) Howard JW, Thomas WG, Judy F, et al : Pharmaco-kinetics of continuous intravenous and subcutaneous infusions of cytosine arabinoside. Blood 59 : 1351-1353, 1982 2) Reiter A, Schrappe M, Ludwig WD, et al : Chemotherapy in 998 unselected childhood acute lymphoblastic leukemia patients. Results and conclusions of the multicenter trial ALL-BFM86. Blood 84 : 3122-3133, 1994 7) Melhorn DK, Samuel Gross MA, Newman AJ : Acute childhood leukemia presenting as aplastic anemia : The response to corticosteroids. J Pediatr 77 : 647-652, 1970 1) Chesslls JM : Treatment of childhood acute lymphoblastic leukemia : Present issues and future prospects. Blood Rev 6 : 193-203, 1992 10) Nand S, Messmore HL, Patel R, et al : Neurotoxicity associated with systemic high-dose cytosine arabinoside. Clin Oncol 4 : 571-575, 1986 8) Ohara A, Kojima S, Hamajima N, et al : Myelodys-plastic syndrome and acute myelogenous leukemia as a late clonal complication in children with acquired aplastic anemia. Blood 90 : 1009-1013, 1997 3) Albano EA, Pizzo PA : Infectious complications in childhood acute leukemias. Pediatr Clin North Am 35 : 873-901, 1988 12) Blaney SM, Balis FM, Poplack DG : Current pharmacological treatment approaches to central nervous system leukemia. Drugs 41 : 702-716, 1991 |
| References_xml | – reference: 4) Chanock SJ, Pizzo PA : Infectious complications of patients undergoing therapy for acute leukemia : Current status and future prospects. Semin Oncol 24 : 132-140, 1997 – reference: 6) 土田嘉昭, 斎藤純夫, 本名敏郎, 他 : 白血病と外科的合併症-特にその外科治療について-.小児外科14 : 777-785, 1982 – reference: 5) Rice MS, Cord-Udy C, Little KE, et al : Surgical complications in acute leukemia in childhood : A 20 year experience. Med Pediatr Oncol 20 : 32-37, 1992 – reference: 7) Melhorn DK, Samuel Gross MA, Newman AJ : Acute childhood leukemia presenting as aplastic anemia : The response to corticosteroids. J Pediatr 77 : 647-652, 1970 – reference: 11) Howard JW, Thomas WG, Judy F, et al : Pharmaco-kinetics of continuous intravenous and subcutaneous infusions of cytosine arabinoside. Blood 59 : 1351-1353, 1982 – reference: 2) Reiter A, Schrappe M, Ludwig WD, et al : Chemotherapy in 998 unselected childhood acute lymphoblastic leukemia patients. Results and conclusions of the multicenter trial ALL-BFM86. Blood 84 : 3122-3133, 1994 – reference: 8) Ohara A, Kojima S, Hamajima N, et al : Myelodys-plastic syndrome and acute myelogenous leukemia as a late clonal complication in children with acquired aplastic anemia. Blood 90 : 1009-1013, 1997 – reference: 12) Blaney SM, Balis FM, Poplack DG : Current pharmacological treatment approaches to central nervous system leukemia. Drugs 41 : 702-716, 1991 – reference: 1) Chesslls JM : Treatment of childhood acute lymphoblastic leukemia : Present issues and future prospects. Blood Rev 6 : 193-203, 1992 – reference: 9) Slevin ML, Piall EM, Aherne GW, et al : Effect of dose and schedule on pharmacokinetics of high-dose cytosine arabinoside in plasma and cerebrospinal fluid. Clin Oncol 1 : 546-551, 1983 – reference: 3) Albano EA, Pizzo PA : Infectious complications in childhood acute leukemias. Pediatr Clin North Am 35 : 873-901, 1988 – reference: 10) Nand S, Messmore HL, Patel R, et al : Neurotoxicity associated with systemic high-dose cytosine arabinoside. Clin Oncol 4 : 571-575, 1986 |
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| SubjectTerms | acute lymphoblastic leukemia bacterial meningitis bone marrow transplantation hydrocephalus ventriculo-peritoneal shunt |
| Title | Unrelated Bone Marrow Transplantation for a Child with Acute Lymphoblastic Leukemia with Ventriculo-Peritoneal Shunt |
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