title: Lymphodepletion chemotherapy followed by donor leukocytes for post-transplantation relapse of myelofibrosis after previous donor leukocyte infusion failure.
abstract: Treatment of relapse after allogenic stem cell transplantation (allo-SCT) is challenging. The efficacy of donor leukocyte infusions (DLI) is excellent in chronic phase chronic myeloid leukaemia but limited in other disorders. We present a patient who relapsed 10 months after reduced intensity conditioning allo-SCT for a myelodysplastic/ myeloproliferative neoplasm with myelofibrosis despite receiving escalating doses of DLI for incomplete chimerism. He finally achieved complete remission with full whole blood and T-cell donor chimerism after DLI preceded by lymphodepletion chemotherapy. This case demonstrates that chemotherapy prior to DLI is a useful approach for treating relapses of relatively slowly progressive diseases, such as myeloproliferative diseases or myelodysplastic syndromes.
authors.affiliation: Department of Haematology, Imperial College at Hammersmith Hospital, London, UK.
authors.forename: Emma Lucy
authors.initials: EL
authors.lastname: Neave
authors.forename: Heike
authors.initials: H
authors.lastname: Schwarb
authors.forename: Abdurrazag
authors.initials: A
authors.lastname: Shlebak
authors.forename: David Mark
authors.initials: DM
authors.lastname: Layton
authors.forename: Jane F
authors.initials: JF
authors.lastname: Apperley
authors.forename: Jiri
authors.initials: J
authors.lastname: Pavlu
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D046528:Chimerism; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007958:Leukocyte Count; D017708:Leukocyte Transfusion; D008212:Lymphocyte Depletion; D008297:Male; D008875:Middle Aged; D054437:Myelodysplastic-Myeloproliferative Diseases / Q000150:complications / Q000188:drug therapy; D009504:Neutrophils / Q000166:cytology; D055728:Primary Myelofibrosis / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D012008:Recurrence; D014184:Transplantation, Homologous