2022 Volume 59 Issue 5 Pages 426-429
The prognosis for patients with recurrent isolated central nervous system (CNS) acute lymphoblastic leukemia (ALL) is considered to be poor. It is considered that these patients should undergo hematopoietic stem cell transplantation, but there are many unanswered questions, such as whether autologous or allogeneic transplantation is better, and whether intrathecal injection (IT) should be performed. In this report, we describe the case of a six-year-old girl with B-cell precursor ALL. Eighteen months after the first relapse during maintenance therapy, the patient had an isolated CNS relapse. After achieving remission, the patient underwent cord blood transplantation after pretreatment, including 12 Gy of total body irradiation and 12 times of IT over 18 months. She has remained in remission for six years. In this patient, it is suggested that allogeneic transplantation and long-term IT can increase the possibility of cure in cases of second isolated CNS relapse after 18 Gy irradiation.
