title: Relapse of Philadelphia chromosome positive acute lymphoblastic leukaemia after marrow transplantation: sustained molecular remission after early and dose-escalating infusion of donor leucocytes.
abstract: We present a patient who underwent sibling allogeneic BMT because of refractory Ph+ve ALL and remained BCR-ABL-positive after marrow grafting. Haemopoietic precursor cells were predominantly BCR-ABL-negative and of donor origin. In T cells an exclusively donor genotype was demonstrated. Despite donor leucocyte infusion (DLI), 20 weeks after BMT BCR-ABL fusion mRNA increased in semiquantitative polymerase chain reaction and leukaemic infiltration of the patient's bone marrow was seen. After a second course of DLI the patient achieved sustained molecular remission but he developed severe graft-versus-host disease (GvHD) and died from bacterial sepsis 9 months after DLI.
authors.affiliation: Department of Medicine I, University of Vienna, Austria.
authors.forename: F
authors.initials: F
authors.lastname: Keil
authors.forename: P
authors.initials: P
authors.lastname: Kalhs
authors.forename: O A
authors.initials: OA
authors.lastname: Haas
authors.forename: G
authors.initials: G
authors.lastname: Fritsch
authors.forename: E
authors.initials: E
authors.lastname: Reiter
authors.forename: C
authors.initials: C
authors.lastname: Mannhalter
authors.forename: K
authors.initials: K
authors.lastname: Lechner
authors.forename: G
authors.initials: G
authors.lastname: Leitner
authors.forename: H T
authors.initials: HT
authors.lastname: Greinix
mesh_terms: D000328:Adult; D016026:Bone Marrow Transplantation / Q000379:methods*; D017809:Fatal Outcome; D006801:Humans; D017708:Leukocyte Transfusion / Q000379:methods*; D008297:Male; D018365:Neoplasm, Residual; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000628:therapy*; D012008:Recurrence; D018183:Transplantation Chimera; D014184:Transplantation, Homologous