title: Successful rapid discontinuation of immunosuppressive therapy at molecular relapse after allogeneic bone marrow transplantation in a pediatric patient with myelodysplastic syndrome.
abstract: The success of allogeneic bone marrow transplantation (allo-BMT) in children with myelodysplastic syndrome (MDS) is mainly affected by relapse. The role of additional immunotherapy for pediatric patients with MDS relapsing after allo-BMT remains to be established. Because immunotherapy is generally more effective for patients who bear a low tumor burden, monitoring of minimal residual diseases (MRD) is essential for early diagnosis at molecular relapse. We report here that a patient with relapsed MDS after allo-BMT was successfully treated by the rapid discontinuation of immunosuppressive therapy at molecular relapse while monitoring Wilms tumor (WT1) gene expression levels. Quantitative analysis of WT1 gene expression appeared to be a useful tool to monitor MRD in the present case.
authors.affiliation: Department of Pediatrics and Developmental Medicine, Gunma University Graduate School, Maebashi, Japan. ktamura@med.gunma-u.ac.jp
authors.forename: Kazushi
authors.initials: K
authors.lastname: Tamura
authors.forename: Takashi
authors.initials: T
authors.lastname: Kanazawa
authors.forename: Michiko
authors.initials: M
authors.lastname: Suzuki
authors.forename: Mikiko
authors.initials: M
authors.lastname: Koitabashi
authors.forename: Chitose
authors.initials: C
authors.lastname: Ogawa
authors.forename: Akihiro
authors.initials: A
authors.lastname: Morikawa
mesh_terms: D000293:Adolescent; D016026:Bone Marrow Transplantation / Q000379:methods*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D009190:Myelodysplastic Syndromes / Q000628:therapy*; D018365:Neoplasm, Residual / Q000175:diagnosis* / Q000188:drug therapy; D012333:RNA, Messenger / Q000032:analysis; D012008:Recurrence; D014184:Transplantation, Homologous; D025721:WT1 Proteins / Q000235:genetics
chemical_list: D007166:Immunosuppressive Agents; D012333:RNA, Messenger; D025721:WT1 Proteins