Treatment of T-prolymphocytic leukemia with nonmyeloablative allogeneic stem cell transplantation.
OBJECTIVE
T-prolymphocytic leukemia (T-PLL) is a rare disease of the elderly characterized by a high white blood cell count and organomegaly, and is currently incurable. Our aim was to elicit graft-versus-leukemia reactions in a patient with T-PLL.


METHODS
A 52-yr-old woman with refractory T-PLL underwent a nonmyeloablative regimen followed by allogeneic peripheral blood stem cell transplantation (a "minitransplant") from her HLA-matched sibling.


RESULTS
There was no treatment related toxicity other than neutropenia. Engraftment was successful. The patient experienced no graft-versus-host disease (GVHD) at any time but, on day 84 after transplantation, had a relapse in the central nervous system. Despite infusion of donor lymphocytes and intralumbar chemotherapy, she died on day 157 of systemic disease.


CONCLUSIONS
The reasons why treatment may have failed are discussed (nature of disease, disease progression, treatment schedule).
Garderet
L
L
Service d'Hématologie-Greffe de Moelle, Hôpital Saint Louis, Paris, France. laurent.garderet@sat.ap-hop-paris.fr
Bittencourt
H
H
Kaliski
A
A
Daniel
M
M
Ribaud
P
P
Socié
G
G
Gluckman
E
E
D005155:Facial Nerve Diseases / Q000209:etiology; D017809:Fatal Outcome; D005260:Female; D006085:Graft Survival; D020544:Graft vs Leukemia Effect; D018380:Hematopoietic Stem Cell Transplantation; D006650:Histocompatibility Testing; D006801:Humans; D015463:Leukemia, Prolymphocytic / Q000628:therapy*; D015458:Leukemia, T-Cell / Q000628:therapy; D008581:Meningitis / Q000209:etiology; D008875:Middle Aged; D009679:Nuclear Family; D012008:Recurrence; D014184:Transplantation, Homologous