Donor leukocyte transfusions and discontinuation of immunosuppressants to achieve an initial remission after allogeneic bone marrow transplantation in a patient with primary refractory acute leukemia

• Published in: Bone marrow transplantation (Basingstoke) Vol. 18; no. 1; pp. 257 - 261
• Main Authors: AZUNO, Y, KANEKO, T, KAMEI, S, ZAITSU, Y, TAKEUCHI, Y, OKA, Y, KAKU, K, NISHIMURA, M, OKUYA, S, NAKAI, K, NOMIYAMA, J, MORI, K, OKAFUJI, K, OKUBO, M, MATSUTANI, A
• Format: Journal Article
• Language: English
• Published: Basingstoke Nature Publishing Group 01.07.1996
• Subjects: Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis; Bone Marrow - pathology; Bone Marrow Transplantation - immunology; Clone Cells - immunology; Clone Cells - pathology; Combined Modality Therapy; Drug Resistance, Neoplasm; Fatal Outcome; Female; Graft vs Host Disease - drug therapy; Graft vs Host Disease - etiology; Graft vs Host Reaction; Humans; Immunosuppressive Agents - administration & dosage; Immunosuppressive Agents - adverse effects; Leukocyte Transfusion; Male; Medical sciences; Methylprednisolone - administration & dosage; Methylprednisolone - adverse effects; Neoplastic Cells, Circulating; Neoplastic Stem Cells - immunology; Neoplastic Stem Cells - pathology; Precursor Cell Lymphoblastic Leukemia-Lymphoma - blood; Precursor Cell Lymphoblastic Leukemia-Lymphoma - pathology; Precursor Cell Lymphoblastic Leukemia-Lymphoma - therapy; Prednisolone - administration & dosage; Prednisolone - adverse effects; Recurrence; Remission Induction; Tissue Donors; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Transplantation, Homologous; Blood product; HLA-System; Discontinuous; Chemoprophylaxis; Transfusion; Leukocyte; Leukemia; Major histocompatibility system; Homograft; Prevention; Bone marrow; Graft; Remission; Mixed lineage; Human; Immunopathology; Acute; Related donor; Graft versus host reaction; Malignant hemopathy; Case study; Treatment; Young adult; Immunosuppressive agent; Histocompatibility
• ISSN: 0268-3369; 1476-5365

We present a female patient who received an allogeneic bone marrow transplantation for primary refractory Philadelphia-positive acute biphenotypic leukemia. Since leukemic blasts were persistently present in peripheral blood and bone marrow, in spite of the evidence for engraftment of male donor hematopoiesis, we performed donor leukocyte transfusions and discontinued immunosuppression. An initial complete remission was obtained 15 weeks after allogeneic bone marrow transplantation, and lasted for 24 weeks. We concluded that the prominent mechanism for the eradication of the refractory leukemic clone in the patient was the graft-versus-leukemia effect.