Frontiers in Medicine (Mar 2022)
Controversial Flow Cytometry Monitoring of a Relapse Case of Pediatric T Cell Acute Lymphoblastic Leukemia: A Case Report
- Delia Codruţa Popa,
- Delia Codruţa Popa,
- Andreea Şerbănică,
- Andreea Şerbănică,
- Radu Obrisca,
- Ionut Şerbănică,
- Letiţia Radu,
- Letiţia Radu,
- Cristina Jercan,
- Cristina Jercan,
- Andra Marcu,
- Andra Marcu,
- Ana Bica,
- Minodora Asan,
- Mădălina Petran,
- Mădălina Petran,
- Mihaela Dragomir,
- Cerasela Jardan,
- Cerasela Jardan,
- Valeria Ţică,
- Anca Gheorghe,
- Irina Stoian,
- Daniel Coriu,
- Daniel Coriu,
- Anca Coliţă,
- Anca Coliţă,
- Andrei Coliţă,
- Andrei Coliţă
Affiliations
- Delia Codruţa Popa
- Department of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Delia Codruţa Popa
- Department of Hematology, Fundeni Clinical Institute, Bucharest, Romania
- Andreea Şerbănică
- Department of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Andreea Şerbănică
- Department of Hematology, Fundeni Clinical Institute, Bucharest, Romania
- Radu Obrisca
- Department of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Ionut Şerbănică
- Department of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Letiţia Radu
- Department of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Letiţia Radu
- Department of Hematology, Fundeni Clinical Institute, Bucharest, Romania
- Cristina Jercan
- Department of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Cristina Jercan
- Department of Hematology, Fundeni Clinical Institute, Bucharest, Romania
- Andra Marcu
- Department of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Andra Marcu
- Department of Hematology, Fundeni Clinical Institute, Bucharest, Romania
- Ana Bica
- Department of Hematology, Fundeni Clinical Institute, Bucharest, Romania
- Minodora Asan
- Department of Hematology, Fundeni Clinical Institute, Bucharest, Romania
- Mădălina Petran
- Department of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Mădălina Petran
- Department of Toxicology, Grigore Alexandrescu Emergency Clinical Hospital for Children, Bucharest, Romania
- Mihaela Dragomir
- Department of Hematology, Fundeni Clinical Institute, Bucharest, Romania
- Cerasela Jardan
- Department of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Cerasela Jardan
- Department of Hematology, Fundeni Clinical Institute, Bucharest, Romania
- Valeria Ţică
- Department of Hematology, Fundeni Clinical Institute, Bucharest, Romania
- Anca Gheorghe
- Department of Hematology, Fundeni Clinical Institute, Bucharest, Romania
- Irina Stoian
- Department of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Daniel Coriu
- Department of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Daniel Coriu
- Department of Hematology, Fundeni Clinical Institute, Bucharest, Romania
- Anca Coliţă
- Department of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Anca Coliţă
- Department of Hematology, Fundeni Clinical Institute, Bucharest, Romania
- Andrei Coliţă
- Department of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Andrei Coliţă
- Department of Hematology, Coltea Hospital, Bucharest, Romania
- DOI
- https://doi.org/10.3389/fmed.2022.858809
- Journal volume & issue
-
Vol. 9
Abstract
Acute lymphoblastic leukemia (ALL) is the most frequent childhood cancer, with 80–85% represented by B cell ALL and only 15% by T cell ALL. T Cell ALL (T-ALL) carries a more reserved prognosis compared to B Cell ALL (B-ALL) with regard to response to treatment, risk of relapse, and overall survival. Progress made in current monitoring protocols such as via flow cytometry immunophenotyping (FCM) and by PCR-based amplification of antigen-receptor genes led to improved management of patients with ALL and superior rates of survival. Nevertheless, challenges remain in some clinical cases. This manuscript describes a unique case of T-ALL and raises awareness of such clinical challenges. The article presents an overview of the flow cytometry immunophenotyping at diagnosis and during treatment of a pediatric patient with T-ALL from Fundeni Clinical Institute. In this case, in spite of various therapeutic measures such as first-line chemotherapy for high risk group, salvage chemotherapy (FLAG), conditioning regimen (FLU-BU-TT-ATG), and stem cell transplant, a chemoresistance clone continued to be present.
Keywords
