Successful engraftment of sibling cord-blood stem cell transplantation in a child with acute promyelocytic leukemia.
Cord blood stem cell transplantation (CBSCT) was performed on a patient with acute promyelocytic leukemia. The patient was a boy 3 years and 8 months old, who had shown complete remission following treatment with intensive chemotherapy. However, after the final course of consolidation chemotherapy, chromosome analysis of his bone marrow aspirates revealed 46XY, t(15,17)(q22;q21), and a PML-RAR alpha fusion gene was detected by the reverse transcriptase-polymerase chain reaction test. All-trans retinoic acid diminished the chromosomal abnormality, but the PML-RAR alpha fusion gene remained. The patient was then treated with CBSCT from an HLA-matched sibling donor. The number of nucleated cells in the cord blood was 2.2 x 10(7)/kg of body weight, and that of granulocyte-macrophage colony-forming units 0.6 x 10(4)/kg. Methotrexate was given, on days 3 and 6, as prophylaxis against graft-versus-host disease (GVHD). The neutrophil count rose to above 500/microliters on day 22. The platelet count exceeded 50,000/microliters on day 48. Platelet transfusions were given 12 times after CBSCT, the last one on day 36. Grade I acute GVHD was treated with steroids. The patient was well and discharged on day 103, without symptoms or laboratory data suggestive of relapse. Following this experience we instituted a project of the Kanagawa Cord Blood Bank, which is scheduled for expansion nationwide.
Ohnuma
K
K
Department of Oncology, Kanagawa Children's Medical Center, Yokohama, Japan.
Toyoda
Y
Y
Nishihira
H
H
Iguchi
A
A
Honda
K
K
Nagao
T
T
Kigasawa
H
H
D000328:Adult; D001771:Blood Banks; D001772:Blood Cell Count; D002675:Child, Preschool; D005260:Female; D005312:Fetal Blood; D016179:Granulocyte Colony-Stimulating Factor / Q000097:blood; D018380:Hematopoietic Stem Cell Transplantation; D006650:Histocompatibility Testing; D006801:Humans; D007231:Infant, Newborn; D007564:Japan; D015473:Leukemia, Promyelocytic, Acute / Q000097:blood / Q000235:genetics / Q000628:therapy*; D008297:Male; D009679:Nuclear Family; D010865:Pilot Projects; D011247:Pregnancy; D014184:Transplantation, Homologous
D016179:Granulocyte Colony-Stimulating Factor