Hinkle A S, Dinndorf P A, Bulas D I, Kapur S
Department of Hematology/Oncology, Children's National Medical Center, George Washington University School of Medicine and Health Sciences, Washington, DC 20010.
Cancer. 1994 Mar 15;73(6):1757-60. doi: 10.1002/1097-0142(19940315)73:6<1757::aid-cncr2820730634>3.0.co;2-m.
Extramedullary involvement of acute lymphoblastic leukemia (ALL) in sites outside the central nervous system (CNS) or testes is rare and may signal a refractory form of leukemia.
The authors describe a child with ALL who experienced a relapse involving the inferior rectus muscle of the eye. This patient had been treated with a bone marrow transplant for previous bone marrow and ovarian relapse.
The patients had a pre-B ALL with a t(1;19) chromosomal translocation and previously had experienced relapse during therapy. At the time of the muscle relapse, she had pancreatomegaly consistent with leukemic infiltration but no CNS or bone marrow disease.
Relapse of ALL in unusual sites may indicate disease that is particularly difficult to eradicate. Factors in addition to age and leukocyte count at diagnosis determined risk. Additional research is needed to define these factors and develop more effective therapy.
急性淋巴细胞白血病（ALL）在中枢神经系统（CNS）或睾丸以外部位的髓外浸润罕见，可能预示着难治性白血病。
作者描述了一名患有ALL的儿童，其复发累及眼内直肌。该患者曾因先前的骨髓和卵巢复发接受过骨髓移植治疗。
该患者为前B-ALL，伴有t(1;19)染色体易位，此前在治疗期间曾复发。在肌肉复发时，她有符合白血病浸润的胰腺肿大，但无CNS或骨髓疾病。
ALL在不寻常部位的复发可能表明疾病特别难以根除。除了诊断时的年龄和白细胞计数外，其他因素也决定风险。需要进一步研究来确定这些因素并开发更有效的治疗方法。
