Donor leukocyte transfusions and discontinuation of immunosuppressants to achieve an initial remission after allogeneic bone marrow transplantation in a patient with primary refractory acute leukemia.
We present a female patient who received an allogeneic bone marrow transplantation for primary refractory Philadelphia-positive acute biphenotypic leukemia. Since leukemic blasts were persistently present in peripheral blood and bone marrow, in spite of the evidence for engraftment of male donor hematopoiesis, we performed donor leukocyte transfusions and discontinued immunosuppression. An initial complete remission was obtained 15 weeks after allogeneic bone marrow transplantation, and lasted for 24 weeks. We concluded that the prominent mechanism for the eradication of the refractory leukemic clone in the patient was the graft-versus-leukemia effect.
Azuno
Y
Y
Department of Internal Medicine, Yamaguchi Rosai Hospital, Japan.
Kaneko
T
T
Nishimura
M
M
Okuya
S
S
Nakai
K
K
Nomiyama
J
J
Mori
K
K
Okafuji
K
K
Okubo
M
M
Matsutani
A
A
Kamei
S
S
Zaitsu
Y
Y
Takeuchi
Y
Y
Oka
Y
Y
Kaku
K
K
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001853:Bone Marrow / Q000473:pathology; D016026:Bone Marrow Transplantation / Q000276:immunology; D002999:Clone Cells / Q000276:immunology / Q000473:pathology; D003131:Combined Modality Therapy; D019008:Drug Resistance, Neoplasm; D017809:Fatal Outcome; D005260:Female; D006086:Graft vs Host Disease / Q000188:drug therapy / Q000209:etiology; D006087:Graft vs Host Reaction; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects*; D017708:Leukocyte Transfusion; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage / Q000009:adverse effects*; D009360:Neoplastic Cells, Circulating; D014411:Neoplastic Stem Cells / Q000276:immunology / Q000473:pathology; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000097:blood / Q000473:pathology / Q000628:therapy*; D011239:Prednisolone / Q000008:administration & dosage / Q000009:adverse effects*; D012008:Recurrence; D012074:Remission Induction; D014019:Tissue Donors; D014184:Transplantation, Homologous
D007166:Immunosuppressive Agents; D011239:Prednisolone; D008775:Methylprednisolone