Chronic myeloid leukemia relapsing ten years after allogenic bone marrow transplantation.
A 58-year-old female was diagnosed with Philadelphia chromosome positive chronic myeloid leukemia (CML) in blast crisis (BC) in 2004. The patient received imatinib, which quickly induced molecular remission, and subsequently underwent bone marrow transplantation (BMT) from an unrelated human leukocyte antigen (HLA)-identical donor. The post-transplant clinical course was essentially uneventful. In 2014, ten years after the BMT, the patient was admitted to our hospital complaining of lymphadenopathy, and blasts were observed in peripheral blood. The patient was diagnosed as having a CML relapse in myeloid BC, with leukemic infiltration in lymph nodes, and was treated with dasatinib. Subsequently, pleural effusion developed and nilotinib was administered, which induced normal blood counts without blasts and partial cytogenetic remission, one month after administration. Six months after the relapse, this patient underwent a second BMT from an HLA-matched unrelated donor. Recent studies have demonstrated the cumulative incidence of CML relapse more than five years after allogeneic hematopoietic stem cell transplantation (allo-HSCT) to be higher than in acute myeloid leukemia. Although rare, the possibility of late relapse should be considered in patients diagnosed with CML after allo-HSCT.
Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital.
Yutaro
Y
Hino
Noriko
N
Doki
Keita
K
Yamamoto
Yasushi
Y
Senoo
Satoshi
S
Sasajima
Masahiro
M
Sakaguchi
Keiichiro
K
Hattori
Satoshi
S
Kaito
Shuhei
S
Kurosawa
Kaito
K
Harada
Shuntaro
S
Ikegawa
Daisuke
D
Watanabe
Takeshi
T
Hagino
Kosuke
K
Yoshioka
Kyoko
K
Watakabe
Aiko
A
Igarashi
Yuho
Y
Najima
Takeshi
T
Kobayashi
Kazuhiko
K
Kakihana
Hisashi
H
Sakamaki
Kazuteru
K
Ohashi
D001706:Biopsy; D016026:Bone Marrow Transplantation; D005260:Female; D016044:Fusion Proteins, bcr-abl / Q000235:genetics; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000235:genetics / Q000473:pathology / Q000628:therapy*; D008875:Middle Aged; D012008:Recurrence; D013997:Time Factors; D014184:Transplantation, Homologous
D016044:Fusion Proteins, bcr-abl