Abstract
A 19-year-old male presented to our institution for bone marrow transplantation (BMT) from a matched unrelated donor. 5 years previously he had been diagnosed with acute lymphoblastic leukaemia, treated with chemotherapy according to a high-risk protocol. Remission was achieved, but CNS relapse was confirmed 2 years later. Further treatment included craniospinal irradiation. A further 2 and a half years had elapsed when further relapse was confirmed by the presence of blasts in the peripheral blood. Over the following 6 months, further remission was achieved, and the patient was referred for BMT. Conditioning chemotherapy of busulphan, cyclophosphamide and Campath (an anti-lymphocyte monoclonal antibody) was given. Following transplantation, cyclosporin A and methotrexate were commenced for graft versus host disease prophylaxis. Immediately post-transplant, neutropenic sepsis developed and was treated with anti-microbial agents. At day 30 posttransplant he suffered tonic–clonic seizures and subsequently a reduced level of consciousness. CT scan was performed which was within normal limits. MRI of the brain was subsequently undertaken (Figures 1 and 2). What abnormality is shown? What is the diagnosis? What is the advice to the clinical team and prognosis of the condition?
Published Version
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call