CD7 Positive Acute Lymphoblastic Leukemia Successfully Treated with High Dose Cytosine Arabinoside and Mitoxantrone: A Case Report.

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  • Nakajima Hideaki
    Divisioin of Hematology, Department of Internal Medicine and Laboratory Medicine, School of Medicine, Keio University
  • Kizaki Masahiro
    Divisioin of Hematology, Department of Internal Medicine and Laboratory Medicine, School of Medicine, Keio University
  • Kawai Yohko
    Divisioin of Hematology, Department of Internal Medicine and Laboratory Medicine, School of Medicine, Keio University
  • Ishida Akaru
    Divisioin of Hematology, Department of Internal Medicine and Laboratory Medicine, School of Medicine, Keio University
  • Tokuhira Michihide
    Divisioin of Hematology, Department of Internal Medicine and Laboratory Medicine, School of Medicine, Keio University
  • Watanabe Kiyoaki
    Divisioin of Hematology, Department of Internal Medicine and Laboratory Medicine, School of Medicine, Keio University
  • Ikeda Yasuo
    Divisioin of Hematology, Department of Internal Medicine and Laboratory Medicine, School of Medicine, Keio University

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Abstract

A 45-year-old woman with acute lymphoblastic leukemia (ALL) who failed to achieve complete remission (CR) after one course of induction chemotherapy with vincristine, daunorubicin, prednisolone and 1-asparaginase was successfully treated with a high dose of cytosine arabinoside (Ara-C) and mitoxantrone. The leukemic blasts were CD7, 19, 33, and 38 antigens positive, and had a rearrangement in the T-cell receptor δ chain gene. The karyotype was normal. Primary induction failure and positivity for myeloid antigens are both reported to be poor prognostic factors for ALL. Nevertheless, this patient was successfully treated with the high dose Ara-C and mitoxantrone, and she remains in CR for over 20 months. Combination chemotherapy with high dose Ara-C and mitoxantron may be of benefit for refractory ALL with both CD7 and myeloid antigens.

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