Persistence of various chromosomal aberrations in recipient cells during complete remission after bone marrow transplantation followed by graft rejection.
A 16-year-old boy in a second remission of acute lymphoblastic leukemia (ALL) had undergone transplantation of bone marrow from an unrelated donor. The conditioning regimen consisted of high-dose cytarabine, etoposide and 12 Gy of total-body irradiation. Although the donor marrow was rejected, hematopoiesis by the recipient himself recovered and he has remained in complete remission for more than 8 years after stem cell transplantation (SCT). Bone marrow karyotype analysis 1 month after SCT showed random chromosomal aberrations. Although complete remission was maintained, various chromosomal aberrations were detected in marrow cells, and in peripheral blood cells under phytohemagglutinin stimulation over 8 years. Moreover, a clone including del(20)(q11) appeared in marrow cells 7 months after SCT and thereafter was also detected 5 years later in the peripheral blood. This persistence of various chromosomal aberrations and a stable clone without evolution to myelodysplastic syndrome or leukemia support the multi step theory of leukemogenesis.
Masuko
Masayoshi
M
Division of Hematology, Graduate School of Medical and Dental Science, Niigata University at Asahimachi-dori 1-754, Niigata 951-8122, Japan.
Furukawa
Tatsuo
T
Yersser
Osman
O
Narita
Miwako
M
Toba
Ken
K
Koike
Tadashi
T
Aizawa
Yoshifusa
Y
D000293:Adolescent; D016026:Bone Marrow Transplantation; D002869:Chromosome Aberrations; D006084:Graft Rejection; D006801:Humans; D007621:Karyotyping; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000235:genetics / Q000628:therapy*; D012074:Remission Induction