Successful immunotherapy in early relapse of acute myeloid leukemia after nonmyeloablative allogeneic stem cell transplantation.
We report on a 35-year-old woman who underwent allogeneic stem cell transplantation (SCT) in second complete remission (CR) of acute myeloid leukemia (AML) after reduced-intensity conditioning with fludarabine and 2 Gy of total body irradiation. For graft-versus-host disease (GVHD) prophylaxis, cyclosporin A (CsA) and mycophenolate mofetil (MMF) were given. On day 27 after SCT complete hematological remission and donor chimerism was documented. However, in CD34(+) bone marrow cells 28% of recipient hematopoiesis persisted. On day +59 leukemic relapse occurred. After discontinuation of CsA and onset of GVHD, complete donor chimerism and hematological CR were achieved which has been maintained for 14 months.
Prinz
E
E
Department of Medicine I, Bone Marrow Transplantation, University Hospital of Vienna, Vienna, Austria. e.prinz@lks.at
Keil
F
F
Kalhs
P
P
Mitterbauer
M
M
Rabitsch
W
W
Rosenmayr
A
A
Moser
K
K
Schulenburg
A
A
Lechner
K
K
Greinix
H T
HT
D000208:Acute Disease; D000328:Adult; D003131:Combined Modality Therapy; D005260:Female; D006086:Graft vs Host Disease / Q000517:prevention & control; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007167:Immunotherapy; D007951:Leukemia, Myeloid / Q000628:therapy*; D012008:Recurrence; D012074:Remission Induction; D019172:Transplantation Conditioning / Q000379:methods*; D014184:Transplantation, Homologous
D007166:Immunosuppressive Agents