Primary renal leukaemia in a young adult male as an extramedullary presentation of T cell acute lymphoblastic leukaemia

Abstract

Primary renal involvement by T lymphoblasts is rare among adults with T acute lymphoblastic leukaemia. We report a 28-year-old man presenting with acute renal failure due to infiltration by T lymphoblasts and his response to paediatric-inspired modified BFM-90 protocol. The patient achieved an initial complete remission (CR) but developed central nervous system relapse. He achieved CR2 with cranial irradiation and intrathecal chemotherapy. He underwent a haploidentical transplant in CR2 and remains in remission post-transplant day 330. An early kidney biopsy helped confirm the diagnosis. Such presentations remain responsive to modified BFM-90. An early allotransplant in CR2 remains the standard of care.

Keywords: Modified BFM‐90 protocol; T cell acute lymphoblastic leukaemia; acute renal failure in T‐ALL; extramedullary manifestations in T‐ALL.