Related Experiment Video
Updated: May 29, 2026
Intracranial Orthotopic Allografting of Medulloblastoma Cells in Immunocompromised Mice
Published on: October 3, 2010
Metachronous B-Cell Acute Lymphoblastic Leukemia After Localized Neuroblastoma Treated Without Cytotoxic Therapy: A
Reihaneh Sedghi1, Ahmad Nazar Zadeh2, Mohammadreza Bordbar3
1Pediatric Hematology Department, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran, sums.ac.ir.
None:
A 7-month-old infant developed therapy-independent acute lymphoblastic leukemia (ALL) 8 months after complete resection of an International Neuroblastoma Risk Group (INRG) Stage L1 adrenal neuroblastoma (N-MYC nonamplified) treated with surgery alone. The patient presented with leukemia cutis and discordant bone marrow findings: the initial aspirate revealed > 90% lymphoblasts (CD45+/CD19+/CD10+/TdT+), whereas two subsequent marrow examinations showed normocellular hematopoiesis, suggesting spatially heterogeneous marrow involvement with predominant extramedullary disease. Skin biopsy confirmed leukemic infiltration (PAX5+/TdT+/CD34+/CD10-). Germline testing was not available. Standard-risk chemotherapy achieved complete remission, and the patient is currently receiving maintenance therapy. This case highlights that second primary ALL can occur in the absence of cytotoxic therapy after neuroblastoma and underscores the need for long-term surveillance and consideration of genetic evaluation in selected patients.