Relapsed chronic myeloid leukemia in accelerated phase 10 years after allogeneic bone marrow transplantation: full chimera reconversion with donor peripheral blood stem cells infusion.
We report the case of a 44-year-old male who relapsed in accelerated phase chronic myeloid leukemia 10 years after a successful bone marrow transplantation from his HLA-identical brother, and 3 years after 12 months treatment with interferon-alpha (IFN-alpha) for chronic active hepatitis C (CAH). The patient was infused with G-CSF-primed peripheral blood cells (PBSC) from the original bone marrow donor and a full donor reconstitution, with no detectable molecular disease, was obtained within 4 months without clinical aplasia or GVHD, nor help from other forms of chemotherapy or use of biological response modifiers. We speculate that IFN-alpha for CAH delayed the onset of a clinical recurrence of chronic myeloid leukemia and that in advanced disease PBSCs can provide an advantageous alternative to donor lymphocyte infusion (DLI).
BMT Unit, Instituto Português de Oncologia, Lisbon, Portugal.
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Guimarães
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Machado
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S
Carvalho
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H
Alaiz
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L
Vieira
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Abecasis
D000328:Adult; D016026:Bone Marrow Transplantation / Q000009:adverse effects; D002678:Chimera / Q000235:genetics; D016044:Fusion Proteins, bcr-abl / Q000235:genetics; D018380:Hematopoietic Stem Cell Transplantation; D006526:Hepatitis C / Q000209:etiology / Q000628:therapy; D006521:Hepatitis, Chronic / Q000209:etiology / Q000628:therapy; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use; D015465:Leukemia, Myeloid, Accelerated Phase / Q000235:genetics / Q000628:therapy*; D008297:Male; D012008:Recurrence; D013997:Time Factors; D014019:Tissue Donors; D014184:Transplantation, Homologous
D016898:Interferon-alpha; D016044:Fusion Proteins, bcr-abl