Relapse of Philadelphia chromosome positive acute lymphoblastic leukaemia after marrow transplantation: sustained molecular remission after early and dose-escalating infusion of donor leucocytes.
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.
Keil
F
F
Department of Medicine I, University of Vienna, Austria.
Kalhs
P
P
Haas
O A
OA
Fritsch
G
G
Reiter
E
E
Mannhalter
C
C
Lechner
K
K
Leitner
G
G
Greinix
H T
HT
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