Clonal expansion after bone marrow transplantation in a patient with chronic myelogenous leukemia.
A patient with chronic myelogenous leukemia (CML) having the standard [t(9;22), Ph] translocation is presented where the Philadelphia (Ph) chromosome disappeared following bone marrow transplantation (BMT). The Ph chromosome reappeared in host cells after one year of stable hematologic remission. Three additional cell lines, all possessing the Ph chromosome with other abnormalities were consistently present in her marrow cells. Two years after BMT, ninety percent of her dividing bone marrow cells had become leukemic. The patient's clinical status remains unchanged, despite complex cytogenetic findings. The high incidence of multiple aberrant leukemic clones present in this case remains intriguing. Possible mechanisms for this unique transformation after BMT are discussed.
Macera
M J
MJ
Long Island College Hospital-SUNY Health Science Center, Brooklyn 11201.
Botti
A C
AC
Verma
R S
RS
Coleman
M
M
Thomas
E D
ED
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016026:Bone Marrow Transplantation; D002460:Cell Line; D002999:Clone Cells / Q000473:pathology*; D003131:Combined Modality Therapy; D005260:Female; D006085:Graft Survival; D006412:Hematopoietic Stem Cells / Q000473:pathology*; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000235:genetics / Q000473:pathology* / Q000628:therapy; D014411:Neoplastic Stem Cells / Q000473:pathology*; D010677:Philadelphia Chromosome; D011828:Radiation Chimera; D012074:Remission Induction