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International Journal of Hematology

, Volume 75, Issue 2, pp 201–206 | Cite as

Treatment of a Child With Myeloid/NK Cell Precursor Acute Leukemia With L-Asparaginase and Unrelated Cord Blood Transplantation

  • Kayo Tezuka
  • Hideki Nakayama
  • Keiko Honda
  • Junji Suzumiya
  • Kouichi Oshima
  • Toshiyuki Kitoh
  • Eiichi Ishiia
Case Report

Abstract

A 2-year-old Japanese boy who presented with multiple cervical, axillary, and inguinal lymphadenopathy was diagnosed by immunocytochemical analysis as having myeloid/natural killer (NK) cell precursor acute leukemia. Leukemic blasts in the bone marrow were positive for CD56 (NK marker), CD7 (T-cell marker), CD33 (myeloid marker), CD34, and HLA-DR. Tumor cells in a lymph node were also positive for CD2, cytoplasmic CD3 (T-cell marker), CD7, CD33, CD34, and CD56, but negative for peroxidase staining and other T-cell, NK, and myeloid markers. Southern blot analysis showed no rearrangement bands for T-cell receptor δ and immunoglobulin heavy chain. Chromosomal analysis revealed 46,XY,inv(7)(p21q21). Neither chemotherapy for acute lymphoblastic leukemia nor that for acute myeloid leukemia induced remission in this patient. How-ever, complete remission was achieved by the administration of L-asparaginase (6000 U/m2 for 5 days). Because the disease was considered refractory to standard chemotherapy, cord blood transplantation was performed from an HLA 1-locus mis-matched unrelated donor. The conditioning regimen consisted of total body irradiation, cytarabine, and cyclophosphamide, and cyclosporine and short-term methotrexate were employed for graft-versus-host disease (GVHD) prophylaxis. Hematological reconstitution was rapid, and only grade I acute GVHD was observed. The patient has been in remission for more than 24 months after transplantation. Our findings indicate that combination therapy with L-asparaginase and allogeneic stem cell transplantation may be useful for the treatment of myeloid/NK cell precursor acute leukemia.

Key words

Childhood leukemia Myeloid/NK cell precursor Chromosomal abnormality Cord blood transplantation L-asparaginase 

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Copyright information

© The Japanese Society of Hematology 2002

Authors and Affiliations

  • Kayo Tezuka
    • 1
  • Hideki Nakayama
    • 1
  • Keiko Honda
    • 1
  • Junji Suzumiya
    • 2
  • Kouichi Oshima
    • 2
  • Toshiyuki Kitoh
    • 3
  • Eiichi Ishiia
    • 4
  1. 1.Division of PediatricsHamanomachi HospitalFukuoka
  2. 2.First Department of Pathology, School of MedicineFukuoka UniversityFukuoka
  3. 3.Department of PediatricsShiga Medical Center for ChildrenShiga
  4. 4.Department of PediatricsSaga Medical SchoolSagaJapan

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