Donor lymphocyte infusions for post-transplant relapse of refractory anemia with excess blasts and monosomy 7.
An 8-year-old male relapsed with refractory anemia with excess blasts (RAEB) and monosomy 7 and mixed chimerism (MC) 21 months after HLA-matched unrelated donor bone marrow transplant (BMT). He received three donor lymphocyte infusions (DLI) using an escalating dose schedule. He developed grade II acute graft-versus-host disease (GVHD) 9 days after the third DLI, but continued to deteriorate for 2 months with decreasing marrow cellularity but persisting blasts, MC, and monosomy 7, before exhibiting a delayed but complete response which has persisted for 5 years. This case suggests that DLI and graft-versus-myelodysplasia (GVMDS) may be beneficial in post-transplant relapse of pediatric myelodysplasia.
Skinner
R
R
Department of Paediatric and Adolescent Oncology, and Children's BMT Unit, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom. Roderick.Skinner@ncl.ac.uk
Velangi
M
M
Bown
N
N
D000754:Anemia, Refractory, with Excess of Blasts / Q000188:drug therapy / Q000235:genetics / Q000601:surgery / Q000628:therapy*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D016026:Bone Marrow Transplantation; D002648:Child; D002897:Chromosomes, Human, Pair 7 / Q000235:genetics*; D003131:Combined Modality Therapy; D006801:Humans; D017710:Lymphocyte Transfusion; D008297:Male; D009006:Monosomy; D012008:Recurrence; D012074:Remission Induction; D014019:Tissue Donors; D019172:Transplantation Conditioning