A successful cord blood transplant in a child with second accelerated phase chronic myeloid leukemia following lymphoid blast crisis.
We describe a 5-year-old girl with Ph(+) CML who received a cord blood transplant in a second accelerated phase after a very early lymphoid blast crisis. She was induced into CR by ALL-directed chemotherapy and then maintained with IFN-alpha2b together with weekly rotational chemotherapy. Nineteen months after diagnosis, her mother gave birth to an HLA-compatible sibling, whose cord blood was cryopreserved. The patient's second acceleration occurred 22 months after the CML diagnosis. The subsequent conditioning regimen included busulfan 16 mg/kg, Ara-C 12 g/m2 and melphalan 140 mg/m2. In order to prevent GVHD, CsA alone was administered, 3 mg/kg i.v. per day for a total of 40 days. The total number of nucleated cells infused was 0.8 x 108/kg, with CD34+ cells 1.8 x 106/kg and CFU-GM 1 x 104/kg. Engraftment occurred on day +35. Respiratory distress, severe VOD and grade II acute gastrointestinal GVHD complicated the post-transplant period. No chronic GVHD occurred. The girl is alive 23 months after transplantation with complete donor chimerism; both Ph chromosome and bcr/abl RNA are negative. Bone Marrow Transplantation (2000) 25, 213-215.
Maschan
A A
AA
Research Institute for Pediatric Hematology of the Russian Federation, Russian Children's Hospital, Moscow, Russian Federation.
Skorobogatova
E V
EV
Samotchatova
E V
EV
Balashov
D N
DN
Yourlova
M I
MI
Bogatcheva
N I
NI
Pashanov
E D
ED
Trakhtman
P E
PE
Timakov
A M
AM
Rumiantzev
A G
AG
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001752:Blast Crisis / Q000150:complications / Q000188:drug therapy / Q000473:pathology* / Q000628:therapy; D016913:Blood Component Transfusion / Q000009:adverse effects; D002675:Child, Preschool; D005260:Female; D005312:Fetal Blood / Q000166:cytology / Q000276:immunology; D006085:Graft Survival; D006086:Graft vs Host Disease / Q000188:drug therapy / Q000209:etiology / Q000276:immunology; D018380:Hematopoietic Stem Cell Transplantation; D006650:Histocompatibility Testing; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000150:complications / Q000188:drug therapy / Q000235:genetics / Q000473:pathology* / Q000628:therapy*; D015465:Leukemia, Myeloid, Accelerated Phase / Q000150:complications / Q000235:genetics / Q000473:pathology* / Q000628:therapy*; D008297:Male; D019172:Transplantation Conditioning / Q000009:adverse effects; D016896:Treatment Outcome