[Long-term remission in an acute monoblastic leukemia patient with down syndrome after cord blood transplantation].

A 4-year-old boy with Down syndrome (DS) was diagnosed as having acute monoblastic leukemia (AML-M5a). Leukemic cells were CD33+, CD56+ and CD4+, with t(9;11) on cytogenetic analysis and MLL gene rearrangement. After 2 courses of induction therapy using an AML 99-Down protocol failed to obtain complete remission, the patient received cord blood transplantation from an HLA-matched donor (CBT) following a conditioning regimen comprising total body irradiation and cyclophosphamide. Only cyclosporin A was used for graft-versus-host disease prophylaxis. Stem cell transplantation may not be indicated for AML patient with DS in first remission, who display a high rate of life-threatening and fatal toxicity on therapy. This patient remained well controlled in complete remission for 4 years, representing a rare case of DS with chemotherapy-resistant AML successfully treated with a CBT.

Burkitt lymphoma associated with large gastric folds, pancreatic involvement, and biliary tract obstruction.

Large gastric folds in adults are seen in many benign and malignant conditions, but they are rare in children with malignant diseases such as non-Hodgkin lymphoma. The authors report a patient with non-Hodgkin lymphoma who had large gastric folds and jaundice as the initial symptoms. A 14-year-old boy was referred to the authors' hospital with upper abdominal pain and jaundice. A standard barium upper gastrointestinal series showed large gastric folds in the entire stomach. Magnetic resonance imaging showed a typical diffuse infiltrating type of pancreatic lymphoma. Because complete bilateral lower limb paralysis developed as a result of the epidural soft tissue mass, laminectomy and tumor resection were performed and a diagnosis of disseminated Burkitt lymphoma was established. After completing 6 months of chemotherapy, the patient has been disease-free without neurologic complications for 2.5 years.