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Imaging findings of recurrent acute lymphoblastic leukemia in children and young adults, with emphasis on MRI

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Abstract

Acute lymphoblastic leukemia (ALL) is the most common of all childhood malignancies. Current remission rates approach 80%. Recurrent disease can present in a wide variety of ways. MR imaging plays a crucial role in the detection of disease relapse. Because other disorders can mimic recurrence of leukemia, it is important for the radiologist to judge recurrence from non-recurrence accurately in order to avoid unnecessary testing and emotional stress on the patient and family.

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References

  1. Margolin JF, Steuber CP, Poplack DG (2001) Acute lymphoblastic leukemia. In: Pizzo PA, Poplack DG (eds) Principles and practice of pediatric oncology, 4th edn. Lippincott, Philadelphia, pp 489–544

  2. Haddy TB, Mosher RB, Reaman GH (2001) Osteoporosis in survivors of acute lymphoblastic leukemia. Oncologist 6:278–285

    CAS  PubMed  Google Scholar 

  3. Rivera GK, Raomondi SC, Hancock ML, et al (1991) Improved outcome in childhood acute lymphoblastic leukemia with reinforced early treatment and rotational combination chemotherapy. Lancet 337:61–66

    Article  CAS  PubMed  Google Scholar 

  4. Henze G, Fengler R, Hartmann R, et al (1991) Six-year experience with a comprehensive approach to the treatment of recurrent childhood acute lymphoblastic leukemia (ALL-REZ BFM 85): A Relapse Study of the BFM Group. Blood 78:1166–1172

    CAS  PubMed  Google Scholar 

  5. Frassoni F, Barrett AJ, Ernst P, et al (1988) Relapse after allogeneic bone marrow transplantation for acute leukaemia: a survey by the E.B.M.T. of 117 cases. Br J Haematol 70:317–320

    CAS  PubMed  Google Scholar 

  6. Sanders JE (1997) Bone marrow transplantation for pediatric malignancies. Pediatr Clin N Am 44:1005–1020

    CAS  Google Scholar 

  7. Madani A, Christophe C, Ferster A, et al (2000) Peri-optic nerve infiltration during leukaemic relapse: MRI diagnosis. Pediatr Radiol 30:30–32

    Article  CAS  PubMed  Google Scholar 

  8. Behrendt H, Leeuwen EF, Schuwirth C, et al (1990) Bone marrow relapse occurring at first relapse in children with acute lymphoblastic leukemia. Med Pediatr Oncol 18:190–196

    CAS  PubMed  Google Scholar 

  9. Amano Y, Takaura J, Kumazaki T (1997) Case report: the MRI diagnosis of bone marrow infraction in a child with leukaemia. Clin Radiol 52:560–561

    CAS  PubMed  Google Scholar 

  10. Jensen KE, Sorensen PG, Thomsen C, et al (1990) Magnetic resonance imaging of the bone marrow in patients with acute leukemia during and after chemotherapy. Acta Radiol 31:361–369

    CAS  PubMed  Google Scholar 

  11. Sahdev I, Weinblatt ME, Lester H, et al (1993) Primary ocular recurrence of leukemia following bone marrow transplant. Pediatr Hematol Oncol 10:279–282

    CAS  PubMed  Google Scholar 

  12. Huang LT, Hsiao CC, Went HH, et al (1996) Neurologic complications of pediatric systemic malignancies. J Formos Med Assoc 95:209–212

    CAS  PubMed  Google Scholar 

  13. Chamberlain MC (1997) Pediatric leptomeningeal metastases: outcome following combined therapy. J Child Neurol 12:53–59

    CAS  PubMed  Google Scholar 

  14. Bleyer WA, Byrne TN (1988) Leptomeningeal cancer in leukemia and solid tumors. Curr Probl Cancer 12:181–238

    CAS  PubMed  Google Scholar 

  15. Hwang W-L, Gau J-P, Hu H-T, et al (1994) Isolated extramedullary relaps of acute lymphoblastic leukemia presenting as an intraspinal mass. Acta Haematol 91:46–48

    CAS  PubMed  Google Scholar 

  16. Krepler P, Jentzsch K, Mayer-Obiditsch J (1975) Lymphoblastic extramedullary spinal tumor during remission of acute lymphoblastic leukemia. Acta Neuropathol 6[Suppl]:213–215

  17. Bunin N, Rivera G, Goode F, et al (1987) Ocular relapse in the anterior chamber in childhood acute lymphoblastic leukemia. J Clin Oncol 5:299–303

    CAS  PubMed  Google Scholar 

  18. Merten D (1992) Diagnostic imaging of mediastinal masses in children. AJR 158:825–832

    CAS  Google Scholar 

  19. Molina PL, Siegal MJ, Glazer HS (1990) Thymic masses on MR imaging. AJR 155:495–500

    CAS  Google Scholar 

  20. Kaste SC (2001) Lymphoma—Controversies in imaging the chest. In: Lucaya J, Strife JL (eds) Pediatric chest imaging. Chest imaging in infants and children. Springer, Heidelberg, pp 209–223

  21. Fletcher BD, Kauffman WM, Kaste SC, et al (1995) Use of Tl-201 to detect untreated pediatric Hodgkin disease. Radiology 196:851–855

    CAS  PubMed  Google Scholar 

  22. Fletcher BD, Xiong X, Kauffman WM, et al (1998) Hodgkin disease: use of Tl-201 to monitor mediastinal involvement after treatment. Radiology 209:471–475

    PubMed  Google Scholar 

  23. Nadel HR (1993) Thallium-201 for oncologic imaging in children. Semin Nucl Med 23:243–254

    Google Scholar 

  24. Siegel MJ, Glazer HS, Wiener JI, et al (1989) Normal and abnormal thymus in childhood: MR imaging. Radiology 172:367–371

    CAS  PubMed  Google Scholar 

  25. Boothroyd AE, Hall-Craggs MA, Dicks-Mireaux C, et al (1992) The magnetic resonance appearances of the normal thymus in children. Clin Radiol 45:378–381

    CAS  PubMed  Google Scholar 

  26. Brisse H, Pacquement H, Burdairon E, et al (1998) Outcome of residual mediastinal masses of thoracic lymphomas in children: impact on management and radiological follow-up strategy. Pediatr Radiol 28:444–450

    Article  CAS  PubMed  Google Scholar 

  27. Elkowitz SS, Leonidas JC, Lopez M, et al (1993) Comparison of CT and MRI in the evaluation of therapeutic response in thoracic Hodgkin disease. Pediatr Radiol 23:301–304

    CAS  PubMed  Google Scholar 

  28. Kulkarni AG, Patil AP, Desai SR (1991) Pericardial Involvement as a presenting feature of acute myeloblastic leukemia. J Assoc Physicians India 40:345–46

    Google Scholar 

  29. Iemura A, Yano H, Kojiro M, et al (1991) Massive cardiac involvement of adult T-Cell leukemia/lymphoma. Arch Pathol Lab Med 115:1052-54

    CAS  PubMed  Google Scholar 

  30. Handa R, Bhatia S, Wali JP, et al (1997) Acute leukemia presenting as pericardial effusion—a case report. Singapore Med J 38:491–492

    CAS  PubMed  Google Scholar 

  31. Furihata M, Ido E, Iwata J, et al (1998) Adult T cell leukemia/lymphoma with massive involvement of cardiac muscle and valves. Pathol Int 48:221–224

    Google Scholar 

  32. Takata J, Taguchi H, Miyoshi I, et al (1998) Cardiac valve invasion in chronic adult T cell leukemia. Heart 80:311–12

    CAS  PubMed  Google Scholar 

  33. Jones DP, Stapleton FB, Dalwinsky D, et al (1990) Renal dysfunction and hyperuricemia at presentation and relapse of acute lymphoblastic leukemia. Med Pediatr Oncol 18:283–286

    CAS  PubMed  Google Scholar 

  34. Kebaili K, Manel AM, Chapelon C, et al (2000) Renal enlargement as presentation of isolated renal relapse in childhood leukemia. J Pediatr Hematol Oncol 22:454–45

    Article  CAS  PubMed  Google Scholar 

  35. Chu J-Y, Cradock TV, Danis RK, et al (1981) Ovarian tumor as manifestation of relapse in acute lymphoblastic leukemia. Cancer 48:377–379

    Google Scholar 

  36. Franck P, Duffner U, Schulze-Seeman W, et al (1998) Testicular relapse after 13 years of complete remission of acute lymphoblastic leukemia. Urol Int 60:239–241

    Article  CAS  PubMed  Google Scholar 

  37. Rivera GK, Pui C-H, Hancock ML, et al (1992) Update of St. Jude Study XI for childhood acute lymphoblastic leukemia. Leukemia 6[Suppl 2]:153–156

  38. Pui CH, Dahl GV, Bowman WP, et al (1985) Elective testicular biopsy during chemotherapy for childhood leukemia is of no clinical value. Lancet III:410–412

    Article  Google Scholar 

  39. Cecalupo AJ, Frankel LS, Sullivan MP (1979) Pelvic and ovarian extramedullary leukemic relapse in young girls. Proc Am Assoc Cancer Res 20:365

    Google Scholar 

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Authors and Affiliations

  1. Department of Diagnostic Imaging, St. Jude Children’s Research Hospital, 332 N. Lauderdale, Memphis, TN 38105-2794, USA

    Rosalyn P. Porter & Sue C. Kaste

  2. Department of Radiology, University of Tennessee, College of Medicine, Memphis, Tennessee, USA

    Sue C. Kaste

Authors
  1. Rosalyn P. Porter
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  2. Sue C. Kaste
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Correspondence to Sue C. Kaste.

Additional information

This study was supported in part by grants P30 CA-21765 and P01 CA20180 from the National Cancer Institute and by the American Lebanese Syrian Associated Charities (ALSAC)

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Porter, R.P., Kaste, S.C. Imaging findings of recurrent acute lymphoblastic leukemia in children and young adults, with emphasis on MRI. Pediatr Radiol 34, 400–408 (2004). https://doi.org/10.1007/s00247-003-1137-9

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  • DOI: https://doi.org/10.1007/s00247-003-1137-9

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