Unrelated Bone Marrow Transplantation for a Child with Acute Lymphoblastic Leukemia with Ventriculo-Peritoneal Shunt

Abstract

An 8-year-old girl with acute lymphoblastic leukemia presented with complications of bacterial meningitis and hydrocephalus during induction therapy. Chemotherapy was applied for meningitis and ventriculo-peritoneal shunt operation was performed for hydrocephalus. Because bone marrow relapse was observed during these treatments, induction therapy was reapplied to obtain complete remission. After then, bone marrow transplantation (BMT) from an unrelated donor was performed. The conditioning regimen consisted of 12 Gy of total body irradiation and cyclophosphamide. Cyclosporin A and short-term methotrexate were used for GVHD prophylaxis. Engraftment was successful, and the patient has since maintained complete remission. The clinical course of this case may provide useful information for BMT of patients with complications of the central nervous system.