Reduced-intensity bone marrow transplantation from an alternative unrelated donor for myelodysplastic syndrome of first-donor origin.
A male patient had a relapse of myelodysplastic syndrome (MDS) 2 years after BMT from a female matched unrelated donor. Conventional cytogenetics, FISH, and short-tandem repeat chimerism analysis proved a relapse of donor origin. He underwent reduced-intensity BMT after a conditioning with fludarabine and busulfan, since he had impaired renal, liver, and pulmonary functions. Chimerism analysis on day 28 after the second BMT showed mixed chimerism of the first and the second donors, which later turned to full second-donor chimerism on day 60. He developed grade II acute GVHD of the skin and cytomegalovirus reactivation, but both were improved with methylprednisolone and ganciclovir, respectively. He remains in complete remission 6 months after the second BMT. Reduced-intensity second BMT from an alternative donor appeared to be a tolerable treatment option for donor-derived leukemia/MDS after the first conventional transplantation.
Komeno
Yukiko
Y
Department of Cell Therapy & Transplantation Medicine, University of Tokyo Hospital, Japan.
Kanda
Yoshinobu
Y
Kandabashi
Koji
K
Kawazu
Masahito
M
Goyama
Susumu
S
Takeshita
Masataka
M
Nannya
Yasuhito
Y
Niino
Miyuki
M
Nakamoto
Tetsuya
T
Kurokawa
Mineo
M
Tsujino
Shiho
S
Ogawa
Seishi
S
Aoki
Katsunori
K
Chiba
Shigeru
S
Motokura
Toru
T
Hirai
Hisamaru
H
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects; D016026:Bone Marrow Transplantation / Q000009:adverse effects* / Q000379:methods*; D016572:Cyclosporine / Q000627:therapeutic use; D006086:Graft vs Host Disease / Q000175:diagnosis / Q000517:prevention & control; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D009190:Myelodysplastic Syndromes / Q000209:etiology* / Q000235:genetics / Q000628:therapy*; D012008:Recurrence; D012074:Remission Induction; D014019:Tissue Donors; D018183:Transplantation Chimera; D019172:Transplantation Conditioning
D007166:Immunosuppressive Agents; D016572:Cyclosporine; D008727:Methotrexate