Testicular relapse in adult acute lymphocytic leukemia: A case report and literature review

Sj, Vukelja; Sj, Swanson; Rd, Knight; Rb, Weiss

doi:10.1002/mpo.2950170220

Cited by 5 publications

(3 citation statements)

References 25 publications

(59 reference statements)

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“…The incidence may be higher in certain populations depending on genetic and treatment-related characteristics 7. While ITR during complete remission of leukaemia has been reported in children, the reports in adults are rare and may represent first sign of systemic relapse 8–10. Studies have shown persistence of isolated microscopic testicular leukaemia after completion of initial treatment which is disconcerting 9.…”

Section: Discussionmentioning

confidence: 99%

Isolated testicular recurrence of B cell acute lymphoblastic leukaemia in an adult: rare case

et al. 2019

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An 80-year-old man who was previously diagnosed with Philadelphia+ B cell-acute lymphoblastic leukaemia (B-ALL) in remission post-allogeneic matched unrelated donor peripheral blood stem cell transplant. Five years later, he was found to have unilateral testicular relapse of Philadelphia+ B-ALL proven by pathology after radical orchiectomy. Bone marrow aspirate and biopsy did not show evidence of leukaemia. Patient was treated with adjuvant radiation therapy and started on dasatinib 50 mg daily. Given his age and absence of disseminated acutelymphoblastic leukaemia (ALL), no adjuvant chemotherapy was utilised. He is monitored with monthly PCR studies. At 1-year follow-up, no findings suggestive of recurrence of ALL have been identified and the patient is maintained on the dasatinib. Although isolated testicular recurrence is common among paediatric population, it is a rare event among adults as it is considered an immunological sanctuary for cancer cells.

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Section: Discussionmentioning

confidence: 99%

Isolated testicular recurrence of B cell acute lymphoblastic leukaemia in an adult: rare case

et al. 2019

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“…data]. There are 12 cases reported in the literature [7], only one was in a case reported as having a cytogenetically ab normal clone in the bone marrow at diagnosis. The pre sent case is the first report in adult Ph ALL.…”

Section: Discussionmentioning

confidence: 99%

Testicular Relapse in Philadelphia Chromosome Positive Acute Lymphoblastic Leukaemia

O'brien

Craig²,

Secker-Walker³

et al. 1993

Acta Haematol

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A case of Philadelphia-positive (Ph) acute lymphoblastic leukaemia (ALL) in a 40-year-old male is presented. At diagnosis, 80% of bone marrow cells were Ph. Remission with normal blood counts was achieved but the marrow became hy-percellular, indicating conversion to chronic granulocytic leukaemia (GCL). The Ph clone persisted with a variable percentage of Ph cells. He developed testicular relapse 38 months from diagnosis. The patient died when engraft-ment with a matched unrelated bone marrow transplant failed. Molecular investigation of DNA prepared from diagnostic and remission bone marrow and from testicular tissue in relapse revealed the same sized rearranged fragment of the BCR gene using a probe to the major breakpoint cluster region. This case confirms that testicular involvement due to infiltration of the testes by the original Ph leukaemic clone may occur as an unusual complication in Ph ALL. Conversion to chronic-phase GCL, a rare occurrence in Ph ALL, may have contributed to the unusually long survival.

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“…This has been described mainly in the pediatric age group, with a reported incidence between 0.5% and 2% [1] and overall 5-year survival of adult patients aged 18-60 years with ALL is 20-35% [2]. There are no statistical data for the testicular relapse of ALL in adults [3,4].…”

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confidence: 99%

A Late Testicular Relapse in an Adult with Acute Lymphoblastic Leukemia, 5 Years after the Diagnosis and 4 Years after Allotransplant—A Rare Case

Epure,

Pop,

Juravle

et al. 2024

Diagnostics

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Acute lymphoblastic leukemia (ALL) is a malignant disorder of lymphoid progenitor cells that affects both pediatric and adult populations. Although isolated testicular or any other organ recurrence can occur in the pediatric population, it is rare in adults. We present images for an atypical case of the late testicular recurrence of acute lymphoblastic leukemia in a 56-year-old man previously diagnosed with ALL pro-T who was in remission following polychemotherapy (GMALL 2013 protocol) and the allotransplantation of peripheral blood stem cells from a related donor. Five years later (2022), the unilateral testicular relapse of ALL was suspected by imaging and diagnosed by immunophenotyping from sperm fluid infiltrated with atypical cells with an immunophenotype concordant with that of the underlying disease (ALL T). Bone marrow aspiration and biopsy showed no evidence of systemic leukemia relapse. Testicular ablation or chemotherapy and irradiation were considered. Given the strictly testicular relapse, orchiectomy would have been useful, but given the abdominal adenopathy, a chemotherapy course with HyperCVAD Block A was first required. Testicular relapse can occur at any age, and the recognition of this is important as it may be the first manifestation of systemic relapse.

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Testicular relapse in adult acute lymphocytic leukemia: A case report and literature review

Cited by 5 publications

References 25 publications

Isolated testicular recurrence of B cell acute lymphoblastic leukaemia in an adult: rare case

Isolated testicular recurrence of B cell acute lymphoblastic leukaemia in an adult: rare case

Testicular Relapse in Philadelphia Chromosome Positive Acute Lymphoblastic Leukaemia

A Late Testicular Relapse in an Adult with Acute Lymphoblastic Leukemia, 5 Years after the Diagnosis and 4 Years after Allotransplant—A Rare Case

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