Data Sheet 1_Case Report: Successful treatment of mixed-phenotype acute leukemia with cauda equina syndrome as the initial manifestation.pdf

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) may be the only potentially curative modality. To our knowledge, this is the first reported case of MPAL presenting with CES at disease onset.</p>Methods<p>We reviewed the clinical data of a 21-year-old man with high-risk myeloid/B-lymphoid MPAL presenting with CES as the initial manifestation.

The patient initially presented with lumbosacral radicular pain and lower limb numbness, which rapidly progressed to fecal and urinary incontinence and inability to ambulate. Comprehensive imaging examinations and sacral biopsy ultimately confirmed myeloid/pre-B lymphoblastic MPAL with cauda equina and lumbosacral nerve root involvement. After the patient achieved complete remission with the combination chemotherapy regimen (MTRix + VD + BCL-2i), which features high blood–nerve-barrier penetration, the patient received myeloablative conditioning based on fractionated total-body irradiation and then underwent matched unrelated donor allo-HSCT.