# Chemotherapy management of a pediatric B-ALL patient with moyamoya disease: a case report

## TL;DR

This case report discusses the rare co-occurrence of B-cell acute lymphoblastic leukemia and Moyamoya disease in a child, emphasizing the need for careful chemotherapy management to avoid neurological complications.

## Contribution

The paper presents a rare case of B-ALL and Moyamoya disease, offering insights into managing chemotherapy to prevent neurological risks.

## Key findings

- The patient had both B-ALL and Moyamoya disease, a rare combination.
- Early recognition and tailored chemotherapy reduced neurological complications.
- The case highlights the importance of monitoring cerebrovascular health during leukemia treatment.

## Abstract

Moyamoya disease is a rare, chronic cerebrovascular disorder characterized by progressive stenosis or occlusion of the terminal portions of the internal carotid arteries and the subsequent development of abnormal compensatory vascular networks. It represents a significant cause of intracranial arteriopathy and is a major etiology of stroke and transient ischemic attack in pediatric populations. We present the case of a 9-year-old boy with confirmed diagnosis of B-cell acute lymphoblastic leukemia (B-ALL), in whom brain MRI findings were suggestive of Moyamoya disease. This report underscores the rarity of the co-occurrence of B-ALL and Moyamoya disease and highlights the importance of early recognition and timely intervention during chemotherapy to reduce the risk of neurological complications. Our findings may offer valuable insights for the chemotherapeutic management of ALL patients with coexisting Moyamoya disease.