Cord blood stem cell transplantation for infantile acute lymphoblastic leukemia after primary cytomegalovirus infection

• Published in: Rinshō ketsueki Vol. 38; no. 11; p. 1229
• Main Authors: Goi, K, Sugita, K, Miyamoto, N, Karakida, N, Nakamura, M, Kojika, S, Iijima, K, Kagami, K, Nakazawa, S
• Format: Journal Article
• Language: Japanese
• Published: Japan 01.11.1997
• Subjects: Antiviral Agents - therapeutic use; Cytomegalovirus Infections - drug therapy; Cytomegalovirus Infections - etiology; Fetal Blood - cytology; Ganciclovir - therapeutic use; Hematopoietic Stem Cell Transplantation; Humans; Infant; Male; Precursor Cell Lymphoblastic Leukemia-Lymphoma - therapy
• ISSN: 0485-1439
• DOI: 10.11406/rinketsu.38.1229

We report a 1-year-old boy with infantile lymphoblastic leukemia in first complete remission who received a cord blood stem cell transplantation (CBSCT) from an HLA identical sibling. We collected 120 ml of cord blood when his brother was born, which contained 4.2 x 10(8) mononuclear cells (4.2 x 10(7)/kg) and 3.1 x 10(5) CFU-GM (3.1 x 10(4)/kg). One month prior to transplantation, he showed persistent fever and liver dysfunction, and was finally diagnosed as having primary cytomegalovirus (CMV) infection which was demonstrated by elevation of serum anti-CMV-IgM. The administration of ganciclovir dramatically improved the clinical symptoms and abnormal laboratory findings, and was continued up to 1 month after transplantation to suppress the CMV reactivation. The preconditioning regimen consisted of busulfan (16 mg/kg/4 days) and cyclophosphamide (120 mg/kg/2 days), and cyclosporin A (CyA) alone was used for graft-versus-host disease (GVHD) prophylaxis. Fever suspicious of grade I GVHD developed on day 19, but subsided by increasing the dose of CyA. The WBC and platelet counts reached greater than 1,000/microliter and 50 x 10(3)/microliter on days 12 and 42, respectively. It is now at 13 months since transplantation, and he remains in a disease free state.