Isolated Pulmonary Leukemic Relapse Following Successful Bone Marrow Transplant in a Child with Acute Lymphoblastic Leukemia

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Abstract
Leukemic relapse and interstitial pneumonitis are common complications for leukemic patients following bone marrow transplantation. The case of a successful bone marrow transplantation patient who developed an interstitial infiltrate on chest roentgenogram 212 days post-transplant that was diagnosed by open lung biopsy and found to be a leukemic relapse of the lung parenchyma was studied. No extrapulmonary sites were involved and the infiltrate cleared in 3 wk with systemic chemotherapy. Pulmonary function tests continued to demonstrate restrictive disease. The patient remained in remission for 9 mo. following pulmonary relapse on systemic chemotherapy. This could illustrates an unusual site of leukemic relapse and the importance of open lung biopsy in the diagnosis of the immunosuppressed patient with a pulmonary infiltrate.