case_images: PMC10468783_01
case_images: Macroscopic and histological findings of skin lesions with infiltration of leukemic cells at relapse (hematoxylin-eosin staining and immunostaining) and macroscopic findings on day 14 of cord blood transplantation (a). Scattered eruptive skin lesions are observed in the abdomen (A1). Pathologically, there is diffuse proliferation of leukemic cells, with positivity for c-kit and HLA-DR. Skin lesions disappeared after the conditioning regimen, and a rash due to acute graft-versus-host disease developed on day 14 of cord blood transplantation (A2). Macroscopic findings of drooping of the right eyelid with extroversion of the eye due to right oculomotor palsy (b) at relapse (B1) and at one month after cord blood transplantation (B2).
case_images: CRIHEM2023-7164742.001.jpg
case_images: PMC10468783_01_CRIHEM2023-7164742.001.jpg
case_images: fig1
case_images: Two months after consolidation therapy, leukemia relapsed (blast cells in bone marrow 48% and WT1-mRNA in peripheral blood 87,000 copies/microg RNA), accompanied by multiple skin lesions that demonstrated leukemic cell infiltration (Figure 1(a)). Drooping of the right eyelid was also observed with extroversion of the eye due to right oculomotor palsy (Figure 1(b)).
case_images: Clinical course following treatment with gilteritinib. *Cytogenetic abnormality by G-banding: 46, XX, t(1; 17)(p34; q21.2). CBT, cord blood transplantation; FluBuMel, fludarabine/busulfan/melphalan; PIR, pre-engraftment immune reaction; GVHD, graft-versus-host disease; WT1, Wilms' tumor 1; FISH, fluorescence in situ hybridization.
case_images: CRIHEM2023-7164742.002.jpg
case_images: PMC10468783_01_CRIHEM2023-7164742.002.jpg
case_images: fig2
case_images: The eye symptoms improved two months after starting gilteritinib, and the patient then underwent CBT (Figure 2).