Abstract
A 7-year-old boy with common ALL followed by secondary leukemia (ANLL, M5b) was reported. He developed common ALL in Jan., 1988 when he was 18 months old. Although a complete remission had been achieved by the TCLSG-11-H2 protocol chemotherapy, the bone marrow relapse developed soon after. After the re-induction therapy, multiple fungal liver abscess was developed. Liver cirrhosis, hypersplenism and portal hypertension has been following. Furthermore, he showed various complications such as pleural effusion and bleeding from esophageal varices. A CNS relapse was found in Apr., 1992. After being treated with intrathecal injections of MTX, HC and Ara-C and 28 Gy of cranial irradiation, additional chemotherapies including high dose MTX were performed and totally 750 mg/m2 of VP 16 were given. ANLL (M5b) was developed in Jan., 1993. The leukemic cells were positive for HLA-DR, CD 13, CD 14, CD 11 and CD 18. They had phagocytic function and O2- producing ability. A chromosomal abnormality was observed as 45XY, -7, -21, +i (21q), t (6, 14) (p22 ; q23). P-glycoproteins were found in 58% of the cells. Although he has been intensively treated, no remission has yet been accomplished. It is now urgent to investigate the mechanisms of the secondary leukemias and to establish effective treatments.
