Heath Jessica L, Aumann Waitman K, Maxfield Charles M, Wechsler Daniel S
Division of Pediatric Hematology-Oncology, University of Vermont, Burlington, VT.
Aflac Cancer & Blood Disorders Center at Children's Healthcare of Atlanta.
J Pediatr Hematol Oncol. 2018 Oct;40(7):e442-e445. doi: 10.1097/MPH.0000000000001085.
Central nervous system (CNS) chloromas are an exceedingly rare presentation of CNS relapse in acute lymphoblastic leukemia (ALL). We report a relapsed ALL patient who presented with 2 separate chloromas and cerebrospinal fluid lymphoblastocytosis, and outline a treatment plan of systemic chemotherapy and CNS-directed radiation therapy. A review of the literature indicates that multiagent chemotherapy combined with CNS radiotherapy is effective, with hematopoietic stem cell transplantation used in half of reported cases. We conclude that intensive systemic multiagent chemotherapy with CNS-directed radiation therapy can be successfully used to treat relapsed pediatric ALL with CNS lymphoblastic chloroma.
中枢神经系统（CNS）绿色瘤是急性淋巴细胞白血病（ALL）中枢神经系统复发的一种极其罕见的表现形式。我们报告了1例复发的ALL患者，该患者出现了2个独立的绿色瘤和脑脊液淋巴细胞增多症，并概述了全身化疗和中枢神经系统定向放射治疗的治疗方案。文献综述表明，多药联合化疗与中枢神经系统放疗是有效的，在报告的病例中有一半使用了造血干细胞移植。我们得出结论，强化全身多药化疗联合中枢神经系统定向放射治疗可成功用于治疗复发的小儿ALL伴中枢神经系统淋巴细胞性绿色瘤。
