A clinical case of pulmonary form of mucormycosis in a child with acute lymphoblastic leukemia

Mucormycosis of the lungs is a severe infectious complication in patients with acute lymphoblastic leukemia, which develops at the stage of high-dose cytostatic therapy. It is characterized by an extremely aggressive, rapidly progressive course and, without specific treatment, is fatal in a short time. Reliable verification of mucor is necessary due to its resistance to the most commonly used antifungal drugs, particularly to voriconazole.The article presents a clinical case of pulmonary mucormycosis in a 12‑year-old child at the stage of diagnosis of acute lymphoblastic leukemia. The first symptoms of the disease (headaches, malaise and weakness, pallor), changes in the general blood count (hyperleukocytosis up to 200 thousand cells/μl, single platelets). Based on the results of the examination, the main diagnosis was verified for acute lymphoblastic leukemia L2, IFT T-II, CD1a-. At the stage of diagnosis of acute lymphoblastic leukemia, the underlying disease was complicated by the development of right-sided pneumonia according to X-ray examination. To verify the etiology of infiltration of lung tissue, broncho-alveolar lavage was directed to microbiological diagnostics, which included studies: enzyme immunoassay, microscopic and cultural. On the aggregate of all the results obtained, invasive mucormycosis was diagnosed and antifungal therapy was started immediately.

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Клинический случай легочной формы мукормикоза у ребенка с острым лимфобластным лейкозом

South Russian Journal of Cancer ◽

10.37748/2686-9039-2021-2-4-5 ◽

2021 ◽

Vol 2 (4) ◽

pp. 38-47

Author(s):

D. A. Kharagezov ◽

Yu. N. Lazutin ◽

E. A. Mirzoyan ◽

A. G. Milakin ◽

O. N. Stateshny ◽

...

Keyword(s):

Acute Lymphoblastic Leukemia ◽

Enzyme Immunoassay ◽

Blood Count ◽

Clinical Case ◽

Lymphoblastic Leukemia ◽

Underlying Disease ◽

Main Diagnosis ◽

X Ray ◽

Pulmonary Mucormycosis ◽

Stage Of Diagnosis

The article presents a clinical case of pulmonary mucormycosis in a 12‑year-old child at the stage of diagnosis of acute lymphoblastic leukemia. The first symptoms of the disease (headaches, malaise and weakness, pallor), changes in the general blood count (hyperleukocytosis up to 200 thousand cells/μl, single platelets). Based on the results of the examination, the main diagnosis was verified for acute lymphoblastic leukemia L2, IFT T-II, CD1a-. At the stage of diagnosis of acute lymphoblastic leukemia, the underlying disease was complicated by the development of right-sided pneumonia according to X-ray examination. To verify the etiology of infiltration of lung tissue, broncho-alveolar lavage was directed to microbiological diagnostics, which included studies: enzyme immunoassay, microscopic and cultural. On the aggregate of all the results obtained, invasive mucormycosis was diagnosed and antifungal therapy was started immediately.

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A Case of Anterior Uveitis in the Presence of Acute Lymphoblastic Leukemia

Russian ophthalmology of children ◽

10.25276/2307-6658-2020-3-50-53 ◽

2020 ◽

pp. 50-53

Author(s):

A.V. Kolesnikov ◽

◽

I.V. Kirsanova ◽

N.S. Tumanova ◽

M.M. Averina ◽

...

Keyword(s):

Acute Lymphoblastic Leukemia ◽

Clinical Case ◽

Complete Blood Count ◽

Lymphoblastic Leukemia ◽

Underlying Disease ◽

Pathological Process ◽

The Body ◽

Cervical Lymph Nodes ◽

Antiinflammatory Therapy ◽

Ocular Manifestations

A clinical case of the development of a rare form of ocular manifestation of acute lymphoblastic leukemia, one of the most common oncological diseases in childhood, is described. A seven-year-old child initially had weakness, decreased appetite, and a single episode of subfebrile condition for two days without catarrhal symptoms. Further, an increase in the cervical lymph nodes was noticed. Then a hemorrhagic rash appeared all over the body. In the complete blood count (CBC) test: erythrocytes (RBC) – 3.8 * 1012 / l, hemoglobin (HGB) – 115 g/L, leukocytes (WBC) – 121*109/L, platelets (PLT) – 22*109/L. The child was admitted to the regional children’s clinical hospital. On examination, 90% of blast cells were detected in the myelogram. Against the background of a confirmed remission of the oncological disease, iridocyclitis of the left eye was diagnosed. It could not be stopped by standard antibacterial and antiinflammatory therapy. After a while, the right eye was also involved in the pathological process. Hematologists confirmed the recurrence of acute lymphoblastic leukemia after bone marrow puncture. The presented clinical case demonstrates the fact that the treatment of ocular manifestations of acute lymphoblastic leukemia can be effective only in the treatment of the underlying disease.

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Lineage specific treatment of adult patients with acute lymphoblastic leukemia in first remission with anti-B4-blocked ricin or high-dose cytarabine

Cancer ◽

10.1002/cncr.11219 ◽

2003 ◽

Vol 97 (6) ◽

pp. 1471-1480 ◽

Cited By ~ 42

Author(s):

Ted P. Szatrowski ◽

Richard K. Dodge ◽

Carol Reynolds ◽

Carol A. Westbrook ◽

Stanley R. Frankel ◽

...

Keyword(s):

Acute Lymphoblastic Leukemia ◽

Lymphoblastic Leukemia ◽

Specific Treatment ◽

Adult Patients ◽

High Dose ◽

High Dose Cytarabine ◽

First Remission

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High-Dose Vincristine Sulfate Liposome Injection for Advanced, Relapsed, and Refractory Adult Philadelphia Chromosome–Negative Acute Lymphoblastic Leukemia

Journal of Clinical Oncology ◽

10.1200/jco.2012.46.2309 ◽

2013 ◽

Vol 31 (6) ◽

pp. 676-683 ◽

Cited By ~ 114

Author(s):

Susan O'Brien ◽

Gary Schiller ◽

John Lister ◽

Lloyd Damon ◽

Stuart Goldberg ◽

...

Keyword(s):

Acute Lymphoblastic Leukemia ◽

Hematopoietic Cell Transplantation ◽

Lymphoblastic Leukemia ◽

Philadelphia Chromosome ◽

Chemotherapy Resistance ◽

High Dose ◽

Rapid Progression ◽

Target Tissue ◽

Vincristine Sulfate ◽

Pivotal Phase

Purpose Relapsed adult acute lymphoblastic leukemia (ALL) is associated with high reinduction mortality, chemotherapy resistance, and rapid progression leading to death. Vincristine sulfate liposome injection (VSLI), sphingomyelin and cholesterol nanoparticle vincristine (VCR), facilitates VCR dose-intensification and densification plus enhances target tissue delivery. We evaluated high-dose VSLI monotherapy in adults with Philadelphia chromosome (Ph) –negative ALL that was multiply relapsed, relapsed and refractory to reinduction, and/or relapsed after hematopoietic cell transplantation (HCT). Patients and Methods Sixty-five adults with Ph-negative ALL in second or greater relapse or whose disease had progressed following two or more leukemia therapies were treated in this pivotal phase II, multinational trial. Intravenous VSLI 2.25 mg/m2, without dose capping, was administered once per week until response, progression, toxicity, or pursuit of HCT. The primary end point was achievement of complete response (CR) or CR with incomplete hematologic recovery (CRi). Results The CR/CRi rate was 20% and overall response rate was 35%. VSLI monotherapy was effective as third-, fourth-, and fifth-line therapy and in patients refractory to other single- and multiagent reinduction therapies. Median CR/CRi duration was 23 weeks (range, 5 to 66 weeks); 12 patients bridged to a post-VSLI HCT, and five patients were long-term survivors. VSLI was generally well tolerated and associated with a low 30-day mortality rate (12%). Conclusion High-dose VSLI monotherapy resulted in meaningful clinical outcomes including durable responses and bridging to HCT in advanced ALL settings. The toxicity profile of VSLI was predictable, manageable, and comparable to standard VCR despite the delivery of large, normally unachievable, individual and cumulative doses of VCR.

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