Successful treatment of JMML relapsed after unrelated allogeneic transplant with cytoreduction followed by DLI and interferon-alpha: evidence for a graft-versus-leukemia effect in non-monosomy-7 JMML.
Relapse is the major cause of treatment failure after allogeneic transplantation of children with juvenile myelomonocytic leukemia (JMML), and the role of post-transplant immunomodulation is poorly understood. We report a 12-month-old child with JMML relapsed after unrelated marrow transplantation who received cytoreduction followed by donor lymphocyte infusion (DLI) with improvement, and after addition of interferon-alpha (IFN) achieved complete donor chimerism. He was weaned from IFN and has maintained complete remission for 19 months. This is the first published report of a patient with non-monosomy-7 JMML responding to post-transplant immunomodulation and suggests a role for DLI plus IFN in these patients.
Pulsipher
M A
MA
Blood and Marrow Transplant Program, Salt Lake City, UT 84132, USA. michael.pulsipher@hsc.utah.edu
Adams
R H
RH
Asch
J
J
Petersen
F B
FB
D000970:Antineoplastic Agents / Q000627:therapeutic use; D016026:Bone Marrow Transplantation / Q000379:methods*; D002869:Chromosome Aberrations; D002897:Chromosomes, Human, Pair 7; D018572:Disease-Free Survival; D020544:Graft vs Leukemia Effect; D006801:Humans; D007223:Infant; D016898:Interferon-alpha / Q000627:therapeutic use*; D015477:Leukemia, Myelomonocytic, Chronic / Q000628:therapy*; D017710:Lymphocyte Transfusion / Q000379:methods*; D012008:Recurrence; D012074:Remission Induction; D018183:Transplantation Chimera; D014184:Transplantation, Homologous; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D016898:Interferon-alpha