Isolated extramedullary relapse of acute lymphocytic leukemia in the maxilla after allogeneic stem cell transplantation

: We report a case of extramedullary relapse of acute lymphocytic leukemia（ALL）in the maxilla of 22-year-old man after an allogeneic stem cell transplantation. Relapse of ALL usually occurs in either the central nerve system or a testis because these organs are independent of systemic immunity. A complete remission had been achieved temporarily by both induction chemotherapy and stem cell transplantation. One year after transplantation, a relapse occurred with an extramedullary mass in the right side of the maxilla. The patient received chemotherapy and local radiation therapy of the mass because the bone marrow was not involved. Bone marrow relapse occurred about 6 months after the extramedullary relapse. Unfortunately, the patient died of sepsis during re-induction therapy. This case is the first domestic report of an isolated extramedullary relapse of ALL in the maxilla after allogeneic stem cell transplantation.

[1]  A. Bakathir,et al.  Relapse of acute lymphoblastic leukemia in the jaw. , 2009, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[2]  T. Owonikoko,et al.  Gemtuzumab therapy for isolated extramedullary AML relapse following allogeneic stem-cell transplant , 2007, Nature Clinical Practice Oncology.

[3]  W. Au,et al.  Isolated gingival relapse of acute lymphoblastic leukemia after transplantation. , 2007, Journal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology.

[4]  P. Farthing,et al.  Leukaemic infiltration of the mandible in a young girl. , 2007, International journal of paediatric dentistry.

[5]  A. Unal,et al.  Facial nerve paralysis and paraplegia as presenting symptoms of acute myeloid leukemia. , 2001, Japanese journal of clinical oncology.

[6]  R. Liang,et al.  Isolated extramedullary relapse of acute lymphoblastic leukaemia after allogeneic bone marrow transplantation , 1999, Bone Marrow Transplantation.

[7]  R. Liang,et al.  Extra‐medullary relapse of leukemia following allogeneic bone marrow transplantation , 1999, Hematological oncology.

[8]  D. Horsman,et al.  High incidence of extramedullary relapse of AML after busulfan/cyclophosphamide conditioning and allogeneic stem cell transplantation , 1998, Bone Marrow Transplantation.

[9]  S. Singhal,et al.  Outcome of acute leukemia relapsing after bone marrow transplantation: utility of second transplants and adoptive immunotherapy , 1997, Bone Marrow Transplantation.

[10]  A. Gratwohl,et al.  Granulocytic sarcoma after allogeneic bone marrow transplantation: a retrospective European multicenter survey. Acute and Chronic Leukemia Working Parties of the European Group for Blood and Marrow Transplantation. , 1996, Bone marrow transplantation.

[11]  B. Toth,et al.  Clinically isolated mandibular relapse in childhood acute leukemia , 1990, Cancer.

[12]  C. Bailey,et al.  Jaw involvement in acute lymphoblastic leukaemia , 1983, British Dental Journal.

[13]  R. Meisel,et al.  Three cases of renal relapse after allogeneic hematopoietic stem cell transplantation for childhood acute lymphoblastic leukemia. , 2006, Haematologica.

[14]  F. Askin,et al.  Isolated extramedullary relapse of acute myelogenous leukemia in a tooth. , 1989, Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc.

[15]  M. Gelfand,et al.  Isolated bone relapse in long-term survivors of acute lymphoblastic leukemia. , 1983, The Journal of pediatrics.