Philadelphia chromosome-positive acute lymphoblastic leukemia rescued with a second allogeneic stem cell transplantation from a haploidentical mother after relapse following cord blood transplantation.
A 32-year-old female patient who had Philadelphia chromosome-positive acute lymphoblastic leukemia underwent cord blood transplantation while in her second remission. However, she had a hematological and central nervous system relapse 3 months later. After reinduction with imatinib mesylate, unmanipulated peripheral blood stem cell transplantation was performed from the patient's haploidentical mother with a reduced-intensity conditioning regimen. Rabbit antithymocyte globulin, tacrolimus, and methylprednisolone were used for prophylaxis of graft-versus-host disease. Engraftment of neutrophils was observed on day 12, and complete donor chimerism was obtained by day 24. The posttransplantation course was uneventful. Although the patient had a relapse 10 months later, this case demonstrated that transplantation from a haploidentical donor is clearly a feasible alternative for patients who desperately need rescue transplantation.
Kai
Tatsuyuki
T
Hematology, Kita-Fukushima Medical Center, Date, Fukushima, Japan. kai@jinsenkai.or.jp
Kimura
Hideo
H
Shiga
Yutaka
Y
Mineishi
Shin
S
Yoshihara
Satoshi
S
Ogawa
Hiroyasu
H
Maruya
Etsuko
E
Saji
Hiroh
H
Ohto
Hitoshi
H
Maruyama
Yukio
Y
D000328:Adult; D000818:Animals; D036101:Cord Blood Stem Cell Transplantation; D005260:Female; D006239:Haplotypes; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D009035:Mothers; D036102:Peripheral Blood Stem Cell Transplantation; D011817:Rabbits; D011859:Radiography; D012074:Remission Induction; D018183:Transplantation Chimera; D019172:Transplantation Conditioning / Q000379:methods; D014184:Transplantation, Homologous; D016896:Treatment Outcome