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2017, Number 3

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Rev Hematol Mex 2017; 18 (3)

Apropos of a young adult with acute lymphoblastic leukemia in third relapse: not everything is lost

Márquez-Pinedo O, Gómez-De León A, Méndez-Ramírez N, Gómez-Almaguer D

Language: Spanish
References: 22
Page: 127-133
PDF size: 365.71 Kb.


ABSTRACT

Adolescents and young adults diagnosed with acute lymphoblastic leukemia (ALL) have an inferior outcome in comparison to those in a pediatric age, with a higher relapse rate and lower probability for long term survival. In this article we describe the case of a 21-year old female patient with Ph-negative B-cell ALL seeking a second opinion after her third relapse. We discuss her treatment, evolution, and current status, reflecting on different available options. There is ongoing discussion as to which is the ideal initial combination for these patients; pediatric-inspired regimens, which include L-asparaginase, have emerged as a highly successful strategy. Furthermore, rituximab has proven to be a useful adjunct for patients with CD20+ ALL. However, in spite of treatment received, a significant proportion of patients will relapse and have a dismal prognosis. The only therapeutic measure with the possibility for cure in this context available in our country is an allogeneic transplant. Recently, haploidentical transplantation has risen as a realistic alternative to increase the probability of survival in relapsed patients with ALL without an HLA-identical donor in resource-limited settings.


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