Infusion of tumor-contaminated bone marrow for autologous rescue after high-dose therapy leading to long-term remission in a patient with relapsed Philadelphia chromosome-positive acute lymphoblastic leukemia.
We report a female patient with relapsed Philadelphia chromosome-positive acute lymphoblastic leukemia remaining in long-term second remission after high-dose radiochemotherapy followed by autologous stem cell rescue with bone marrow showing evidence of residual disease. The Philadelphia chromosome and a positive signal for the BCR/ABL p185 translocation by the polymerase chain reaction were detected in the harvested marrow. After mafosfamide-purged marrow failed to engraft, her unpurged 'back-up' bone marrow was also infused. Control marrow examinations after recovery were repeatedly positive for the BCR/ABL translocation on PCR analysis turning negative 30 months after high-dose therapy. She remains in unsustained complete clinical remission for 48+ months showing no evidence of leukemia by cytological and cytogenetic analyses.
Peters
S O
SO
Knochenmarktransplantationszentrum, Abt. Onkologie/Hämatologie, Universitätsklinik Eppendorf, Hamburg, Germany.
Stockschläder
M
M
Hegewisch-Becker
S
S
Krüger
W
W
Weh
H J
HJ
Hossfeld
D K
DK
Zander
A R
AR
D000328:Adult; D016465:Bone Marrow Purging; D016026:Bone Marrow Transplantation; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000031:analogs & derivatives; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D010677:Philadelphia Chromosome; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000235:genetics / Q000628:therapy*; D012074:Remission Induction; D014178:Translocation, Genetic
C048341:mafosfamide; D003520:Cyclophosphamide