Leukemia in Children

Kaplan, Joel A.

doi:10.1542/pir.2018-0192

Cited by 48 publications

(45 citation statements)

References 27 publications

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“…While other potentially less hepatotoxic induction regimens can be used in treating ALL in its initial stages, the most common induction regimen for T-ALL involves the above drugs. 14 Finally, our patient needed continued monitoring of his liver enzymes and synthetic function markers, necessitating multiple additional clinic and lab visits during his initial diagnosis and therapy. Continued supportive care was also required including ursodiol for cholestasis and gallstone prevention.…”

Section: Discussionmentioning

confidence: 99%

Acute lymphoblastic leukemia presenting as cholestatic jaundice in a 7-year-old boy

Ford

Rainey

Hanson

et al. 2019

SAGE Open Medical Case Reports

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This is a case of a 7-year-old boy with acute lymphoblastic leukemia presenting with cholestasis and elevated transaminase levels. Acute lymphoblastic leukemia is the most common malignancy in children and can have variable presenting clinical manifestations. However, cholestasis is less commonly encountered in the pediatric population and can be a diagnostic challenge. We present a case of a 7-year-old boy discovered to have elevated transaminase levels while undergoing an evaluation for motor tics, which subsequently progressed to cholestasis and acute liver failure secondary to acute lymphoblastic leukemia. He demonstrated marked improvement after induction therapy and is in clinical remission. Clinicians should be ever mindful of the potentially unique presentations of childhood leukemia.

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Section: Discussionmentioning

confidence: 99%

Acute lymphoblastic leukemia presenting as cholestatic jaundice in a 7-year-old boy

Ford

Rainey

Hanson

et al. 2019

SAGE Open Medical Case Reports

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“…Among childhood cancers, leukaemia (mainly acute lymphoblastic leukaemia) is the most common 2 . The chemotherapy treatment of acute leukaemia includes three main phases: (1) an induction phase, (2) a consolidation phase whose aim is to destroy all tumour cells in the blood and bone marrow and (3) a maintenance chemotherapy to prolong remission in patients 3 . According to several clinical studies, the conventional chemotherapy is presumed with low risk for fertility 4 – 6 .…”

Section: Introductionmentioning

confidence: 99%

Paradoxical risk of reduced fertility after exposure of prepubertal mice to vincristine or cyclophosphamide at low gonadotoxic doses in humans

Delessard

Saulnier

Dumont

et al. 2020

Sci Rep

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Cancer treatment can have long-term side effects in cured patients and infertility is one of them. Given the urgency of diagnosis in children with cancer, the toxicity of treatments on the gonad was overshadowed for a long time. In the present study, prepubertal mice were treated by vincristine or cyclophosphamide commonly used in acute leukaemia treatment. The prepubertal exposure to cyclophosphamide, at a low gonadotoxic dose in humans (< 3.5 g/m2), led to morphological alterations of prepubertal testicular tissue. An increased proportion of spermatozoa with hypocondensed chromatin and oxidized DNA associated with decreased fertility were uncovered at adulthood. Short- and long-term morphological alterations of the testicular tissue, disturbed progression of spermatogenesis along with increased proportions of isolated flagella and spermatozoa with fragmented DNA were evidenced in vincristine-treated mice. Moreover, the fertility of mice exposed to vincristine was severely affected despite being considered low-risk for fertility in humans. Paternal exposure to vincristine or cyclophosphamide before puberty had no impact on offspring development. Contrary to the current gonadotoxic risk classification, our results using a mouse model show that vincristine and cyclophosphamide (< 3.5 g/m2) present a high gonadotoxic risk when administered before the initiation of spermatogenesis.

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“…However, extra-medullary involvement is frequent, with particular predilection for central nervous system, lymphnodes, soft tissue, skin, and spleen. Mediastinal masses are found infrequently [3]. [4].…”

Section: Introductionmentioning

confidence: 99%

“…Initial presentation with primarily testicular disease is exceedingly rare [8,9]. Fever is commonly noted at presentation, with other clinical manifestations which may include fatigue, palor, petechiae, bleeding, lymphadenopathy and hepatosplenomegaly [3].…”

Section: Introductionmentioning

confidence: 99%

Acute Lymphoblastic Leukemia with Primary Testicular Involvement in a Pre-pubertal Male: A Case Report

Osho¹,

Ojo²,

Osho³

et al. 2020

CRJ

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Acute lymphoblastic leukaemia is the most common malignancy in paediatric patients; its diagnosis is usually easy to establish as malignant lymphoblasts invade the bone marrow and peripheral blood. Patients with Acute lymphoblastic leukaemia (ALL) may initially present with pancytopenia and a hypoplastic or hyperplastic bone marrow. Fever is common at presentation, and despite neutropenia, sepsis is rarely seen. Other common clinical manifestations include fatigue, pallor, petechiae, bleeding, lymphadenopathy and hepatosplenomegaly. Presentation with primarily testicular disease is exceedingly rare in acute lymphoblastic leukemia. The unusual presentation of a primary left testicular involvement in ALL is being highlighted in this case report. We present an 11 year old boy who presented with fever, generalized body pain, abdominal discomfort as well as left testicular swelling. Bone marrow studies, Full blood count and peripheral blood film appearance were typical of acute lymphoblastic leukaemia. Ultrasound findings showed left scrotal enlargement with reduced and coarse parenchymal echotexture, while cytogenetic studies revealed positive Philadelphia chromosomes. There was good response to standard ALL therapy. Clinical remission with normal left testicular size was noted at the end of induction phase of therapy.

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Leukemia in Children

Cited by 48 publications

References 27 publications

Acute lymphoblastic leukemia presenting as cholestatic jaundice in a 7-year-old boy

Acute lymphoblastic leukemia presenting as cholestatic jaundice in a 7-year-old boy

Paradoxical risk of reduced fertility after exposure of prepubertal mice to vincristine or cyclophosphamide at low gonadotoxic doses in humans

Acute Lymphoblastic Leukemia with Primary Testicular Involvement in a Pre-pubertal Male: A Case Report

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