Abstract
The patient was a 13-year-old boy who was hospitalized because of genaral fatigue, low grade fever and cervical lymphadenopathy. On admission lymphoblasts were present as many as 85% of leukocytes in peripheral blood and 97.5% of nucleated cells in bone marrow. These lymphoblasts were 8-15 μ in diameter. The electron microscopy revealed Gall bodies and cytoplasmic fibrils in about 30% and 80% of the lymphoblasts, respectively. E-rosette formation was observed in less than 0.4% of the lymphoblasts at 0°C and less than 0.6% at 37°C. EAC-rosette formation was observed in 3.2% of the cells.
He attained complete remission about 6 weeks after the initiation of the chemotherapy with prednisolone and vincristine.
However, testicular involvement developed, and soon hematological relapse occurred. When relapsed, 90.0% of the lymphoblasts formed E-rosette at 0°C, but only 0.2% of them displayed E-rosette formation at 37°C. More than 99% of the cells reacted with rabbit anti-human thymocyte globulin. Electron microscopically, the Gall bodies decreased in frequency, but the cytoplasmic fibrils were still frequent.
Thereafter complete remission was not attained despite intensive chemotherapy.
About 4 months after the admission, the lymphoblasts formed E-rosette not only at 0°C (50.0%) but also at 37°C (21.3%).
