Table 1 Demographic data cases 1–5
Parameter | Case 1 | Case 2 | Case 3 | Case 4 | Case 5 |
|---|---|---|---|---|---|
Age (years) | 4 | 7 | 11 | 18 | 3 |
Gender | Female | Female | Male | Male | Male |
Clinical | Cervical Lymphadenopathy and leucocytosis | Fever, abdominal distention, hepatosplenomegaly | Vomiting, diarrhoea, lower limb weakness | Epistaxis, ecchymosis skin lesions | Fever, lymphadenopathy and hepatomegaly |
WBC (109/L) | 137 | 18 | 100,8 | 221 | 18.8 |
HB (g/dl) | 5.2 | 4.8 | 7.2 | 11 | 8.7 |
PLT (X109/L) | 9 | 53 | 109 | 34 | 239 |
PB blasts | 80% | 60% | No blasts | 40% | 6% |
Bone marrow aspirate | Hypercellular Blasts 90% B-ALL phenotype | Hypercellular Blasts 80% B-ALL phenotype | 40% blasts and 50% eosinophils | 40% blasts on PB and 70% blasts on BM | Hypercellular Blasts 75% Myelomonocytic proliferation with M4 AML |
Blasts | 90% | 60% | 40% | 70% | 75% |
Disease | B-ALL | B-ALL | B-ALL | T-ALL | AML FAB M4 |
Cytogenetic analysis (karyotype/FISH) | 46, XX,1-, 8-, 9-, 11-, 12-, 19-, and 22- in 80% of cells) | 2n-,44, XX,- 4, −8). t (12; 17). ETV/RUNX 1. Loss of der (12-) MYC gene rearrangement. | t (5;14) Negative: PDGFRA PDGFRB FGFR1 | 46,XY,t(3;11;19) (q21; q23; q13.1). MLL gene rearranged; extra MYC gene | 48,XY,+ 8,+ 8,t(11;17) (p15;q21) [14]/47, idem,-Y |
Chemotherapy | Very high risk ALL chemotherapy protocol (COG AALL0031) and intensive consolidation | Standard risk chemotherapy protocol (COG AALL0331). | high-risk protocol COG AALL0232 with high dose methotrexate for maintenance | Dana Farber then FLAG-Ida salvage chemotherapy high dose | MRC AML12 protocol. |
Survival | Partial remission | Complete remission status achieved | Complete remission | Relapsed and demised | Death due to multiorgan failure |