Transient mixed chimerism after stem cell transplantation can induce durable molecular complete remissions in chronic myelogenous leukemia.
Three patients with BCR/ABL+ chronic myelogenous leukemia were allografted, two with unrelated compatible placental blood and one from a human leukocyte antigen compatible sibling. The patients engrafted successfully, achieved mixed chimerism and all cleared the BCR/ABL fusion transcript. Despíte the fact that the three patients lost the chimerism, they have remained in complete molecular remissions 9 months, 16 months and 5 years, respectively, after the allografts. It is possible that the transient induction of a graft-vs.-leukemia effect was able to control the malignancy despite the fact that the three patients lost the graft; however, other possible explanations are discussed. A longer follow-up of the patients is mandatory to further clarify these observations.
Ruiz-Argüelles
Guillermo J
GJ
Centro de Hematología y Medicina Interna de Puebla, Puebla, Pue, Mexico. gruiz1@clinicaruiz.com
Gómez-Almaguer
David
D
Ruiz-Delgado
Guillermo J
GJ
Tarin-Arzaga
Luz Del C
Ldel C
D000328:Adult; D002648:Child; D002675:Child, Preschool; D046528:Chimerism; D018572:Disease-Free Survival; D005260:Female; D016044:Fusion Proteins, bcr-abl / Q000378:metabolism; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000235:genetics* / Q000378:metabolism / Q000628:therapy*; D008297:Male; D012074:Remission Induction; D033581:Stem Cell Transplantation / Q000379:methods*; D018183:Transplantation Chimera / Q000235:genetics*; D014184:Transplantation, Homologous
D016044:Fusion Proteins, bcr-abl