World Journal of
Pharmaceutical and Life Sciences

ISOLATED TESTICULAR RELAPSE IN CHILDHOOD ACUTE LYMPHOBLASTIC LEUKEMIA

Dr. Md. Golam Hafiz, Professor Dr. Chowdhury Yakub Jamal and Professor Dr. Md. Anwarul Karim

ABSTRACT

Testes have been considered as a sanctuary site for leukemic cells in acute lymphoblastic leukemia. Isolated testicular relapses results in poor outcomes in boys as compared to girls. Testes are one of the most common extramedullary sites of relapse in acute lymphoblastic leukemia. With chemotherapy and or radiotherapy isolated testicular relapses are completely cured. The study was aimed to observe the incidence and outcome of isolated testicular relapse in leukemic child. Nine diagnosed children with acute lymphoblastic leukemia between 4-11 years were enrolled. Most of the child presented with anemia, bone pain and organomegaly. The children who developed testicular swelling had undergone testicular biopsy. All enrolled children had received chemotherapy (MRC 841 protocols) along with testicular irradiation and maintenance therapy. They underwent complete remission during induction and local field irradiation. One child had developed hepatitis with typhlitis and succumbed subsequently during maintenance therapy. Three children had bone marrow relapse during maintenance phase and expired at sixteen months of therapy. The remaining five children had completed maintenance therapy within the stipulated time of 24 months. One child had developed bone marrow relapse following six months of chemotherapy. The rest four children had second remission following completion of maintenance therapy with disease-free survival of 48 to 120 months. Evaluating endocrine and sexual function of the survived children who normally progressed to puberty. Testosterone replacement therapy was given in one child who developed normally. Ten years' event-free survival of the survived children with aggressive therapy was 43.5% without any significant adverse effects. So, chemotherapy and or radiotherapy in schedule dose and duration in an isolated testicular relapse in acute lymphoblastic leukemia has good outcome.

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