Allogeneic Bone Marrow Transplantation in a Child with Myelodysplastic Syndrome (CMMoL) from HLA-Mismatched, MLR-Reactive Uncle

• Published in: The Japanese Journal of Pediatric Hematology Vol. 7; no. 1; pp. 91 - 96
• Main Authors: AONUMA, Kesashi, SHIOHARA, Junko, AMANO, Yoshiro, KOIKE, Kenichi, SHIOHARA, Masaaki, NAKAHATA, Tatsutoshi, ONO, Masana, KOMIYAMA, Atsushi
• Format: Journal Article
• Language: Japanese
• Published: THE JAPANESE SOCIETY OF PEDIATRIC HEMATOLOGY/ONCOLOGY 1993; 特定非営利活動法人 日本小児血液・がん学会
• Subjects: 7-monosomy; bone marrow transplantation; CMMoL
• ISSN: 0913-8706; 1884-4723
• DOI: 10.11412/jjph1987.7.91

A 1-year-old boy with myelodysplastic syndrome had been treated with bone marrow transplantation using HLA-non-identical donor after 4 courses of subcutaneous administration of low-dose cytosine arabinoside (Ara-C). His laboratory data on first medical examination showed : WBC 11, 200/μ1; monocytes 2, 100/p1; blasts 1%; Hb 7.3 g/dl ; plt 7.6×104/μl. A bone marrow examination showed normal cellularity with 12% of blasts and trilineage dysplasia. Cytogenetic studies revealed all of the metaphases to be 45, XY, -7. A diagnosis of chronic myelomonocytic leukemia was made. Pre-conditioning regimen consisted of Ara-C, cyclophosphamide, and total body irradiation. Graft-versus-host disease (GVHD) prophylaxis consisted of cyclosporine, short-term methotrexate, and prednisolone. His peripheral neutrophil count increased to over 500/μl on day +20. But five months later, he relapsed and developed acute leukemia which was refractory to chemotherapies. He died 12 months after BMT. An autopsy revealed generalized infiltration of leukemic cells and aspergillosis of the lung.