[Long-term remission in an acute monoblastic leukemia patient with down syndrome after cord blood transplantation].
A 4-year-old boy with Down syndrome (DS) was diagnosed as having acute monoblastic leukemia (AML-M5a). Leukemic cells were CD33+, CD56+ and CD4+, with t(9;11) on cytogenetic analysis and MLL gene rearrangement. After 2 courses of induction therapy using an AML 99-Down protocol failed to obtain complete remission, the patient received cord blood transplantation from an HLA-matched donor (CBT) following a conditioning regimen comprising total body irradiation and cyclophosphamide. Only cyclosporin A was used for graft-versus-host disease prophylaxis. Stem cell transplantation may not be indicated for AML patient with DS in first remission, who display a high rate of life-threatening and fatal toxicity on therapy. This patient remained well controlled in complete remission for 4 years, representing a rare case of DS with chemotherapy-resistant AML successfully treated with a CBT.
Kurosawa
Hidemitsu
H
Department of Pediatrics, Dokkyo University School of Medicine.
Tsuboi
Tatsuo
T
Shimaoka
Hagane
H
Okuya
Mayuko
M
Nakajima
Daisuke
D
Matsunaga
Takayuki
T
Hagisawa
Susumu
S
Sato
Yuya
Y
Sugita
Kenichi
K
Eguchi
Mitsuoki
M
D002675:Child, Preschool; D036101:Cord Blood Stem Cell Transplantation; D016572:Cyclosporine / Q000008:administration & dosage; D004314:Down Syndrome / Q000150:complications*; D006086:Graft vs Host Disease / Q000517:prevention & control; D006801:Humans; D007948:Leukemia, Monocytic, Acute / Q000175:diagnosis / Q000235:genetics / Q000628:therapy*; D008297:Male; D012074:Remission Induction; D013997:Time Factors; D019172:Transplantation Conditioning; D016896:Treatment Outcome
D016572:Cyclosporine