Yamazaki Rie, Takayama Nobuyuki, Hamano Yasuhiro, Mori Takehiko, Okamoto Shinichiro, Ikeda Yasuo
Division of Hematology, Department of Internal Medicine, Keio University School of Medicine.
Rinsho Ketsueki. 2002 Nov;43(11):1004-8.
Recurrence of Burkitt's lymphoma (BL)/acute lymphoblastic leukemia (ALL)-L3 after a long-term remission is very rare. We herein report on a case of BL/ALL-L3 indicating solitary recurrence in the tonsil after a 3-year remission. A 50-year-old man was diagnosed as having Burkitt's type ALL-L3 with involvement of the stomach and abdominal lymph nodes. He was treated with intensive chemotherapy consisting of methotrexate and cyclophosphamide (ALL-BFM86 protocol), and a complete remission was achieved. After sustaining the remission for three years, a swelling of the right tonsil was observed, which was histologically diagnosed as Burkitt's lymphoma. No other organ involvement, including the bone marrow, was observed. The pattern of c-myc rearrangement of the tonsil demonstrated by southern blotting was identical to that of the bone marrow at initial presentation and the recurrence of primary ALL-L3/BL was thus confirmed. The patient was then treated with the ALL-BFM86 protocol and subsequently underwent high-dose chemoradiotherapy with autologous peripheral blood stem cell transplantation (PBSCT). He has now been in complete remission for more than 2 years after his PBSCT.
伯基特淋巴瘤（BL）/急性淋巴细胞白血病（ALL）-L3在长期缓解后复发极为罕见。我们在此报告一例BL/ALL-L3病例，该病例在缓解3年后扁桃体出现孤立性复发。一名50岁男性被诊断为伯基特型ALL-L3，累及胃部和腹部淋巴结。他接受了由甲氨蝶呤和环磷酰胺组成的强化化疗（ALL-BFM86方案），并实现了完全缓解。在维持缓解三年后，观察到右侧扁桃体肿大，经组织学诊断为伯基特淋巴瘤。未观察到包括骨髓在内的其他器官受累。通过Southern印迹法检测扁桃体的c-myc重排模式与初始发病时骨髓的模式相同，从而证实了原发性ALL-L3/BL的复发。该患者随后接受了ALL-BFM86方案治疗，随后接受了高剂量放化疗并进行了自体外周血干细胞移植（PBSCT）。自PBSCT后，他现已完全缓解超过2年。
