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Case Reports
. 2022 Sep 8:10:960126.
doi: 10.3389/fped.2022.960126. eCollection 2022.

Successful hematopoietic stem cell transplantation for two patients with relapse of intrachromosomal amplification of chromosome 21-positive B-cell precursor acute lymphoblastic leukemia

Tomoya Harada  1 , Hidemi Toyoda  1 , Naoki Tsuboya  1 , Ryo Hanaki  1 , Keishiro Amano  1 , Masahiro Hirayama  1
Affiliations
Case Reports

Successful hematopoietic stem cell transplantation for two patients with relapse of intrachromosomal amplification of chromosome 21-positive B-cell precursor acute lymphoblastic leukemia

Tomoya Harada et al. Front Pediatr. .

Abstract

In children with relapsed acute lymphoblastic leukemia (ALL), it is essential to identify patients in need of treatment intensification. Minimal residual disease (MRD)-based treatment stratification resulted in excellent survival in children with late relapsed B-cell precursor (BCP)-ALL. Chemotherapy alone produced a favorable outcome in patients with negative MRD after induction. The genetic abnormality also plays an important role in determining the prognosis and stratification for treatment. Intrachromosomal amplification of chromosome 21 (iAMP21) is associated with a poor outcome and a high risk for relapse, and there is no standard treatment after relapse. Herein, we present two patients with relapsed iAMP21-positive ALL who were successfully treated by cord blood transplantation (CBT). Although both patients had late bone marrow relapse and favorable MRD response, CBT was performed due to iAMP21 positive. Patients 1 and 2 have been in remission post-CBT for 15 and 45 months, respectively. Patients with relapsed iAMP21-positive ALL may be considered for stem cell transplantation even in late relapses and favorable MRD response.

Keywords: B-cell precursor acute lymphoblastic leukemia; hematopoietic stem cell transplantation; iAMP21; late bone marrow relapse; minimal residual disease; relapsed acute lymphoblastic leukemia.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Fluorescence in situ hybridization (FISH) analysis of Case 1 on interphase with an LSI ETV6/RUNX1 ES dual color probe. RUNX1 signals are in red, and ETV6 signals are green. (A) Cells at disease onset. (B) Cell at relapse.
FIGURE 2
FIGURE 2
FISH analysis of Case 2 on interphase and metaphase with an LSI ETV6/RUNX1 ES dual color probe. RUNX1 signals are in red, and ETV6 signals are green. (A) An interphase cell at relapse. (B) A metaphase cell at relapse.
See this image and copyright information in PMC

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