Relapse of Philadelphia chromosome positive acute lymphoblastic leukaemia after marrow transplantation: sustained molecular remission after early and dose-escalating infusion of donor leucocytes |
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| Authors: | Felix,Keil ,Peter,Kalhs ,Oskar A.,Haas ,Gerhard,Fritsch ,Elisabeth,Reiter ,Christine,Mannhalter ,Klaus,Lechner ,Gerda,Leitner & Hildegard T.,Greinix |
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| Affiliation: | Department of Medicine I, Bone Marrow Transplantation Unit, University of Vienna; Children's Cancer Research Institute, St Anna Kinderspital; Clinical Institute for Medical and Chemical Laboratory Diagnostic, University of Vienna, Austria; Department of Medicine I, Division of Haematology and Haemostaseology, University of Vienna, Austria;, Department of Transfusion Medicine, University of Vienna, Austria |
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| Abstract: | We present a patient who underwent sibling allogeneic BMT because of refractory Ph+ve ALL and remained BCR-ABL-positive after marrow grafting. Haemopoietic precursor cells were predominantly BCR-ABL-negative and of donor origin. In T cells an exclusively donor genotype was demonstrated. Despite donor leucocyte infusion (DLI), 20 weeks after BMT BCR-ABL fusion mRNA increased in semiquantitative polymerase chain reaction and leukaemic infiltration of the patient's bone marrow was seen. After a second course of DLI the patient achieved sustained molecular remission but he developed severe graft-versus-host disease (GvHD) and died from bacterial sepsis 9 months after DLI. |
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| Keywords: | allogeneic marrow transplantation Ph+ve ALL donor leucocyte infusion |
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