Successful treatment of minimal residual disease-positive Philadelphia chromosome-positive acute lymphoblastic leukemia with imatinib followed by reduced-intensity unrelated cord blood transplantation after allogeneic peripheral blood stem cell transplantation.
We describe a 35-year-old woman with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL) who received allogeneic sibling donor peripheral blood stem cell transplantation (PBSCT) and entered a second complete remission. Upon detection of BCR-ABL transcripts after PBSCT, the patient received imatinib, leading to molecular remission. Following the failure of donor leukocyte infusions, she underwent reduced-intensity unrelated cord blood transplantation (RI-UCBT), and has continued durable molecular remission for more than 30 months without substantial graft-versus-host disease. Because of a lack of adverse effects of imatinib on transplantation outcome, a treatment strategy consisting of molecular monitoring-guided initiation of imatinib followed by RI-UCBT may be promising in the management of Ph+ ALL after allogeneic SCT.
Takami
Akiyoshi
A
Department of Cellular Transplantation Biology, Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa, Japan. takami@med3.m.kanazawa-u.ac.jp
Shimadoi
Shigeru
S
Sugimori
Chiharu
C
Takemoto
Kenichi
K
Shibayama
Masami
M
Yoshida
Tomotaka
T
Murayama
Tohru
T
Nagai
Kenichi
K
Miyamura
Koichi
K
Asakura
Hidesaku
H
Nakao
Shinji
S
D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D001549:Benzamides; D003131:Combined Modality Therapy; D036101:Cord Blood Stem Cell Transplantation; D005260:Female; D006801:Humans; D000068877:Imatinib Mesylate; D018365:Neoplasm, Residual; D036102:Peripheral Blood Stem Cell Transplantation; D010879:Piperazines / Q000008:administration & dosage*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000235:genetics / Q000628:therapy*; D011743:Pyrimidines / Q000008:administration & dosage*; D014184:Transplantation, Homologous
D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate