Prolonged remission of accelerated phase Philadelphia chromosome negative chronic myeloid leukemia following autologous recovery of normal hematopoietic elements after busulfan/cyclophosphamide and allogeneic marrow transplantation.
We describe here a patient with accelerated phase Philadelphia chromosome (Ph1) negative chronic myelogenous leukemia without BCR gene rearrangement, who received an allogeneic bone marrow transplant following a conditioning regimen consisting of busulfan (BU) and cyclophosphamide (CY). Hematopoiesis was restored following splenectomy performed 1 month post-transplant. There were no distinguishing cytogenetic differences between donor and host. Five years post-transplant the patient relapsed with the original disease. Restriction fragment length polymorphism (RFLP) studies performed at that time exhibited host specific DNA markers suggesting recurrent leukemia of host origin. RFLP analysis of the cells cryopreserved immediately post-transplant also revealed all cells to be of host origin. This patient experienced 5 years of remission with autologous hematopoietic recovery from an aggressive myeloproliferative disorder after high dose BU and CY without engraftment of donor hematopoietic cells.
Ohio State University, Division of Bone Marrow Transplantation, Columbus 43210.
N
N
Kapoor
C A
CA
Keever
S H
SH
Hsu
E A
EA
Copelan
P J
PJ
Tutschka
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016465:Bone Marrow Purging; D016026:Bone Marrow Transplantation; D002066:Busulfan / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D005819:Genetic Markers; D006085:Graft Survival; D006801:Humans; D006918:Hydroxyurea / Q000008:administration & dosage; D015465:Leukemia, Myeloid, Accelerated Phase / Q000188:drug therapy / Q000601:surgery*; D054438:Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative / Q000188:drug therapy / Q000601:surgery*; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000473:pathology; D012150:Polymorphism, Restriction Fragment Length; D012074:Remission Induction; D013156:Splenectomy; D014184:Transplantation, Homologous
D005819:Genetic Markers; D003520:Cyclophosphamide; D002066:Busulfan; D006918:Hydroxyurea