{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T15:35:12Z","timestamp":1761060912122,"version":"3.44.0"},"reference-count":22,"publisher":"BMJ","issue":"10","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,10,16]]},"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:p>An 80-year-old man who was previously diagnosed with Philadelphia+ B cell-acute lymphoblastic leukaemia (B-ALL) in remission post-allogeneic matched unrelated donor peripheral blood stem cell transplant. Five years later, he was found to have unilateral testicular relapse of Philadelphia+ B-ALL proven by pathology after radical orchiectomy. Bone marrow aspirate and biopsy did not show evidence of leukaemia. Patient was treated with adjuvant radiation therapy and started on dasatinib 50\u2009mg daily. Given his age and absence of disseminated acutelymphoblastic leukaemia (ALL), no adjuvant chemotherapy was utilised. He is monitored with monthly PCR studies. At 1-year follow-up, no findings suggestive of recurrence of ALL have been identified and the patient is maintained on the dasatinib. Although isolated testicular recurrence is common among paediatric population, it is a rare event among adults as it is considered an immunological sanctuary for cancer cells.<\/jats:p>","DOI":"10.1136\/bcr-2019-232286","type":"journal-article","created":{"date-parts":[[2019,11,1]],"date-time":"2019-11-01T06:49:44Z","timestamp":1572590984000},"page":"e232286","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Isolated testicular recurrence of B cell acute lymphoblastic leukaemia in an adult: rare case"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3636-0353","authenticated-orcid":false,"given":"Thejus","family":"Jayakrishnan","sequence":"first","affiliation":[{"name":"Internal Medicine, Allegheny Health Network, Pittsburgh, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hira","family":"Shaikh","sequence":"additional","affiliation":[{"name":"Internal Medicine, Allegheny Health Network, Pittsburgh, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yazan","family":"Samhouri","sequence":"additional","affiliation":[{"name":"Medical Oncology, Allegheny Health Network, Pittsburgh, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ariel","family":"Sandhu","sequence":"additional","affiliation":[{"name":"Pathology, Allegheny Health Network, Pittsburgh, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salman","family":"Fazal","sequence":"additional","affiliation":[{"name":"Medical Oncology, Allegheny Health Network, Pittsburgh, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,10,31]]},"reference":[{"key":"2025082713125128000_12.10.e232286.1","doi-asserted-by":"crossref","DOI":"10.1002\/pbc.26928","article-title":"Isolated late testicular relapse of B-cell acute lymphoblastic leukemia treated with intensive systemic chemotherapy and response-based testicular radiation: a children's Oncology Group study","volume":"65","author":"Barredo","year":"2018","journal-title":"Pediatr Blood Cancer"},{"key":"2025082713125128000_12.10.e232286.2","doi-asserted-by":"crossref","DOI":"10.4084\/mjhid.2013.024","article-title":"Acute lymphoblastic leukemia experience: epidemiology and outcome of two different regimens","volume":"5","author":"Abbasi","year":"2013","journal-title":"Mediterr J Hematol Infect Dis"},{"key":"2025082713125128000_12.10.e232286.3","doi-asserted-by":"crossref","DOI":"10.1002\/pbc.26977","article-title":"Is testicular irradiation necessary for patients with acute lymphoblastic leukemia and testicular relapse?","volume":"65","author":"Pui","year":"2018","journal-title":"Pediatr Blood Cancer"},{"key":"2025082713125128000_12.10.e232286.4","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2011-12-399287"},{"key":"2025082713125128000_12.10.e232286.5","doi-asserted-by":"publisher","DOI":"10.1038\/leu.2008.251"},{"key":"2025082713125128000_12.10.e232286.6","doi-asserted-by":"crossref","unstructured":"Ding L-W , Sun Q-Y , Mayakonda A , et al . Mutational profiling of acute lymphoblastic leukemia with testicular relapse. J Hematol Oncol 2017;10.doi:10.1186\/s13045-017-0434-y","DOI":"10.1186\/s13045-017-0434-y"},{"key":"2025082713125128000_12.10.e232286.7","doi-asserted-by":"crossref","first-page":"134","DOI":"10.4103\/0019-509X.63002","article-title":"Testicular relapse in childhood acute lymphoblastic leukemia: the challenges and lessons","volume":"47","author":"Kulkarni","year":"2010","journal-title":"Indian J Cancer"},{"key":"2025082713125128000_12.10.e232286.8","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1002\/mpo.2950170220","article-title":"Testicular relapse in adult acute lymphocytic leukemia: a case report and literature review","volume":"17","author":"Vukelja","year":"1989","journal-title":"Med Pediatr Oncol"},{"key":"2025082713125128000_12.10.e232286.9","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1038\/sj.bmt.1701340","article-title":"Isolated testicular relapse after bone marrow transplant with total body irradiation and testicular boost in acute lymphoblastic leukemia","volume":"22","author":"Li","year":"1998","journal-title":"Bone Marrow Transplant"},{"key":"2025082713125128000_12.10.e232286.10","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1038\/sj.bmt.1700948","article-title":"Testicular relapse of acute promyelocytic leukemia after allogeneic BMT","volume":"20","author":"Forrest","year":"1997","journal-title":"Bone Marrow Transplant"},{"key":"2025082713125128000_12.10.e232286.11","doi-asserted-by":"crossref","first-page":"2023","DOI":"10.1016\/j.bbmt.2014.08.023","article-title":"Extramedullary relapse of acute leukemia after haploidentical hematopoietic stem cell transplantation: incidence, risk factors, treatment, and clinical outcomes","volume":"20","author":"X-D","year":"2014","journal-title":"Biol Blood Marrow Transplant J Am Soc Blood MarrowTransplant"},{"key":"2025082713125128000_12.10.e232286.12","doi-asserted-by":"crossref","first-page":"1065","DOI":"10.1038\/bmt.2017.64","article-title":"Successful chimeric Ag receptor modified T cell therapy for isolated testicular relapse after hematopoietic cell transplantation in an acute lymphoblastic leukemia patient","volume":"52","author":"Yu","year":"2017","journal-title":"Bone Marrow Transplant"},{"key":"2025082713125128000_12.10.e232286.13","doi-asserted-by":"publisher","DOI":"10.1016\/0165-0378(90)90028-5"},{"key":"2025082713125128000_12.10.e232286.14","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1038\/bjc.1993.166","article-title":"A rodent model for testicular involvement in acute lymphoblastic leukaemia","volume":"67","author":"Jahnukainen","year":"1993","journal-title":"Br J Cancer"},{"key":"2025082713125128000_12.10.e232286.15","doi-asserted-by":"publisher","DOI":"10.1097\/00043426-199809000-00007"},{"key":"2025082713125128000_12.10.e232286.16","doi-asserted-by":"publisher","DOI":"10.4103\/0019-509X.16694"},{"key":"2025082713125128000_12.10.e232286.17","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1001\/jamacardio.2016.3894","article-title":"Abrupt onset of refractory heart failure associated with light-chain amyloidosis in hypertrophic cardiomyopathy","volume":"2","author":"Tomberli","year":"2017","journal-title":"JAMA Cardiol"},{"key":"2025082713125128000_12.10.e232286.18","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1111\/j.1399-3046.2008.01023.x","article-title":"Continued complete remission without systemic therapy for isolated testicular relapse after bone marrow transplantation in a boy with acute lymphoblastic leukemia","volume":"13","author":"Kodama","year":"2009","journal-title":"Pediatr Transplant"},{"key":"2025082713125128000_12.10.e232286.19","unstructured":"Thacker LR , McCune TR , Harland RC . Kidney sharing by centers of the south-eastern organ procurement Foundation. Clin Transpl 1996:129\u201337."},{"key":"2025082713125128000_12.10.e232286.20","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1007\/s12185-009-0393-3","article-title":"Detection of submicroscopic disease in the bone marrow and unaffected testis of a child with T-cell acute lymphoblastic leukemia who experienced \u201cisolated\u201d testicular relapse","volume":"90","author":"Arima","year":"2009","journal-title":"Int J Hematol"},{"key":"2025082713125128000_12.10.e232286.21","doi-asserted-by":"crossref","first-page":"624","DOI":"10.1200\/JCO.1992.10.4.624","article-title":"Treatment of occult or late overt testicular relapse in children with acute lymphoblastic leukemia: a pediatric Oncology Group study","volume":"10","author":"Wofford","year":"1992","journal-title":"Journal of Clinical Oncology"},{"key":"2025082713125128000_12.10.e232286.22","doi-asserted-by":"crossref","first-page":"672","DOI":"10.1200\/JCO.1990.8.4.672","article-title":"Treatment of isolated testicular relapse in childhood acute lymphoblastic leukemia: an Italian multicenter study. Associazione Italiana Ematologia ED Oncologia Pediatrica","volume":"8","author":"Uderzo","year":"1990","journal-title":"Journal of Clinical Oncology"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2019-232286","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T20:12:58Z","timestamp":1756325578000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2019-232286"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10]]},"references-count":22,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2019,10,31]]},"published-print":{"date-parts":[[2019,10]]}},"alternative-id":["10.1136\/bcr-2019-232286"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2019-232286","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2019,10]]}}}