AUTHOR=Popa Delia Codruţa , Şerbănică Andreea , Obrisca Radu , Şerbănică Ionut , Radu Letiţia , Jercan Cristina , Marcu Andra , Bica Ana , Asan Minodora , Petran Mădălina , Dragomir Mihaela , Jardan Cerasela , Ţică Valeria , Gheorghe Anca , Stoian Irina , Coriu Daniel , Coliţă Anca , Coliţă Andrei TITLE=Controversial Flow Cytometry Monitoring of a Relapse Case of Pediatric T Cell Acute Lymphoblastic Leukemia: A Case Report JOURNAL=Frontiers in Medicine VOLUME=9 YEAR=2022 URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2022.858809 DOI=10.3389/fmed.2022.858809 ISSN=2296-858X ABSTRACT=

Acute lymphoblastic leukemia (ALL) is the most frequent childhood cancer, with 80–85% represented by B cell ALL and only 15% by T cell ALL. T Cell ALL (T-ALL) carries a more reserved prognosis compared to B Cell ALL (B-ALL) with regard to response to treatment, risk of relapse, and overall survival. Progress made in current monitoring protocols such as via flow cytometry immunophenotyping (FCM) and by PCR-based amplification of antigen-receptor genes led to improved management of patients with ALL and superior rates of survival. Nevertheless, challenges remain in some clinical cases. This manuscript describes a unique case of T-ALL and raises awareness of such clinical challenges. The article presents an overview of the flow cytometry immunophenotyping at diagnosis and during treatment of a pediatric patient with T-ALL from Fundeni Clinical Institute. In this case, in spite of various therapeutic measures such as first-line chemotherapy for high risk group, salvage chemotherapy (FLAG), conditioning regimen (FLU-BU-TT-ATG), and stem cell transplant, a chemoresistance clone continued to be present.