Adoptive cell-mediated immunotherapy with interleukin-2 (IL-2) for relapsing lymphoblastic crisis following mismatched unrelated bone marrow transplantation in a chronic myelogenous leukemia patient.
A 21-year-old woman with chronic myelogenous leukemia (CML) relapsed into lymphoblastic crisis with new chromosomal translocations, 4 months following mismatched unrelated allogeneic bone marrow transplantation (BMT). Adoptive cell-mediated immunotherapy with mismatched unrelated donor lymphocytes followed by 3 days of in vivo interleukin-2 (IL-2) resulted in complete remission including disappearance of the Philadelphia chromosome as determined by cytogenetic analysis and the bcr/abl translocation detected by PCR. Lymphoblastic crisis following mismatched, unrelated BMT is relatively rare. Moreover lymphoblastic malignancies usually respond less favorably to cell-mediated immunotherapy. This case is the first reported CML lymphoblastic crisis following mismatched unrelated BMT that responded to cell-mediated immunotherapy and IL-2. Some possible mechanisms and new therapeutic directions are discussed.
Varadi
G
G
Department of Bone Marrow Transplantation, Hadassah University Hospital, Jerusalem, Israel.
Ackerstein
A
A
Ben-Neriah
S
S
Nagler
A
A
D000328:Adult; D001752:Blast Crisis / Q000628:therapy*; D016026:Bone Marrow Transplantation / Q000009:adverse effects / Q000276:immunology; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology; D006801:Humans; D016219:Immunotherapy, Adoptive; D007376:Interleukin-2 / Q000627:therapeutic use*; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000473:pathology / Q000628:therapy*
D007376:Interleukin-2