Murray J C, Gmoser D J, Barnes D A, Oshman D, Hawkins H K, Gresik M V, Dreyer Z E
Section of Hematology-Oncology, Baylor College of Medicine, Houston, Texas.
Med Pediatr Oncol. 1994;23(2):153-7. doi: 10.1002/mpo.2950230217.
An 11-year-old boy with prior bone marrow and testicular relapses of his acute lymphoblastic leukemia (ALL) developed an isolated metatarsal bone relapse during complete hematologic remission 10 months after completion of chemotherapy. Although there was no radiographic or histologic evidence of additional occult leukemia, the polymerase chain reaction (PCR) technique detected a leukemic clone in both his bone marrow and metatarsal. A literature survey revealed only 10 reported cases of isolated bone relapse occurring during complete bone marrow remission in childhood ALL. Most of these patients had prior bone marrow or extramedullary relapses. The majority experienced subsequent relapses after their isolated bone recurrence. We report a case of isolated bone recurrence, review all previously reported cases, and suggest that PCR elucidation of clonal disease may provide a better understanding of these extremely rare extramedullary events.
一名11岁的男孩，之前患有急性淋巴细胞白血病（ALL），出现过骨髓和睾丸复发，在完成化疗10个月后的完全血液学缓解期发生了孤立的跖骨复发。尽管没有影像学或组织学证据表明存在其他隐匿性白血病，但聚合酶链反应（PCR）技术在其骨髓和跖骨中均检测到白血病克隆。文献调查显示，仅有10例报道的儿童ALL患者在完全骨髓缓解期发生孤立性骨复发。这些患者大多数之前有过骨髓或髓外复发。大多数患者在孤立性骨复发后出现后续复发。我们报告一例孤立性骨复发病例，回顾所有先前报道的病例，并提出通过PCR阐明克隆性疾病可能有助于更好地理解这些极其罕见的髓外事件。
