Establishment of donor hematopoiesis after hydroxyurea-induced aplasia following allograft failure in a patient with monosomy 7 variant of childhood chronic myelogenous leukemia.
Monosomy 7 variant childhood chronic myelogenous leukemia (CML) is a rare, fatal leukemia that usually terminates in blast crisis. We report successful marrow transplantation in a patient with this disease using his one HLA locus mismatched mother. Initially following transplant the patient exhibited mixed hematopoietic chimerism, cytogenetic relapse, and clinical relapse of leukemia. However, following recovery from a period of hydroxyurea-induced aplasia, marrow studies showed elimination of the mixed chimerism, absence of the 45,XY,-7 leukemic clone and full engraftment with donor marrow (46,XX). The ability of hydroxyurea to eliminate mixed chimerism in favor of donor hematopoiesis and to eliminate the persistent leukemic clone in this patient with CML suggests treatment approaches worthy of future investigation.
Cassano
W F
WF
Division of Pediatric Hematology-Oncology, University of Florida, Gainesville 32610.
D001853:Bone Marrow / Q000187:drug effects; D016026:Bone Marrow Transplantation; D002678:Chimera / Q000187:drug effects; D002872:Chromosome Deletion; D002897:Chromosomes, Human, Pair 7; D005260:Female; D006084:Graft Rejection; D006410:Hematopoiesis / Q000187:drug effects*; D006801:Humans; D006918:Hydroxyurea / Q000627:therapeutic use*; D007223:Infant; D007621:Karyotyping; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000235:genetics* / Q000473:pathology / Q000601:surgery; D008297:Male; D009006:Monosomy; D014019:Tissue Donors
D006918:Hydroxyurea