T-cell ALL in ataxia telangiectasia cured with only 7 weeks of anti-leukemic therapy

J Pediatr Hematol Oncol. 2015 Mar;37(2):154-5. doi: 10.1097/MPH.0000000000000151.

Abstract

A 20-month-old girl diagnosed with T-cell acute lymphoblastic leukemia was treated according to the Nordic NOPHO ALL2000 protocol. The patient developed severe immunosuppression and experienced life-threatening adenovirus infection, which was treated with ribavirin and cidofovir. α-fetoprotein was 20- to 30-fold elevated, and genetic analysis confirmed the diagnosis of ataxia telangiectasia. Despite receiving only 7 weeks of anti-leukemic therapy, she has stayed in first remission now 8 years after the diagnosis. We speculate that this could be because of increased chemosensitivity of ATM-mutated leukemic cells, adenovirus causing a direct oncolytic effect, and/or high levels of endogenous cortisol during her severe infection.

Publication types

  • Case Reports

MeSH terms

  • Adenoviridae / drug effects
  • Adenovirus Infections, Human / complications*
  • Adenovirus Infections, Human / virology
  • Antiviral Agents / therapeutic use
  • Ataxia Telangiectasia / complications*
  • Ataxia Telangiectasia / virology
  • Female
  • Humans
  • Infant
  • Precursor T-Cell Lymphoblastic Leukemia-Lymphoma / drug therapy*
  • Precursor T-Cell Lymphoblastic Leukemia-Lymphoma / etiology
  • Prognosis
  • Remission Induction

Substances

  • Antiviral Agents