Durable molecular remission in a patient with chronic myelogenous leukemia and host-derived hematopoiesis after allogeneic bone marrow transplantation

Masatoshi Wakui, Shinichiro Okamoto, A. Ishida, Ryuji Tanosaki, Takehiko Mori, Y. Kawai, S. Ohshima, Y. Ikeda

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7 Citations (Scopus)

Abstract

A 44-year-old woman with Ph-positive CML was treated with TBI, splenic irradiation, Ara-C, and CY. She then received unmanipulated marrow cells from her HLA-identical brother. GVHD prophylaxis was FK506 and MTX. WBC counts reached 1000/μl on day 28 when all metaphases of marrow cells showed 46XY. However, on day 42, 46XX was detected in two of 20 metaphases, and the percentage of cells with female karyotype subsequently increased. On day 519, all metaphases showed female karyotype. BCR-ABL mRNA and Philadelphia chromosome were never detected throughout her post-transplant course. Fluorescence in situ hybridization (FISH) revealed complete recovery of host derived hematopoiesis in the bone marrow, however, mixed T cell chimerism in the peripheral blood. This suggests that the persistence of donor-derived T cells may prevent disease recurrence through graft-versus-leukemia effect. The patient remains in a molecular complete remission with host-derived hematopoiesis 749 days post-transplant.

Original languageEnglish
Pages (from-to)801-804
Number of pages4
JournalBone Marrow Transplantation
Volume18
Issue number4
Publication statusPublished - 1996 Oct

Fingerprint

Homologous Transplantation
Hematopoiesis
Metaphase
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Bone Marrow Transplantation
Bone Marrow
Transplants
Karyotype
T-Lymphocytes
Philadelphia Chromosome
Chimerism
Cytarabine
Tacrolimus
Fluorescence In Situ Hybridization
Siblings
Leukemia
Tissue Donors
Recurrence
Messenger RNA

Keywords

  • Allogeneic bone marrow transplantation
  • Autologous hematopoiesis
  • Chronic myelogenous leukemia
  • Graft-versus-leukemia effects
  • Mixed chimerism
  • Molecular remission

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

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title = "Durable molecular remission in a patient with chronic myelogenous leukemia and host-derived hematopoiesis after allogeneic bone marrow transplantation",
abstract = "A 44-year-old woman with Ph-positive CML was treated with TBI, splenic irradiation, Ara-C, and CY. She then received unmanipulated marrow cells from her HLA-identical brother. GVHD prophylaxis was FK506 and MTX. WBC counts reached 1000/μl on day 28 when all metaphases of marrow cells showed 46XY. However, on day 42, 46XX was detected in two of 20 metaphases, and the percentage of cells with female karyotype subsequently increased. On day 519, all metaphases showed female karyotype. BCR-ABL mRNA and Philadelphia chromosome were never detected throughout her post-transplant course. Fluorescence in situ hybridization (FISH) revealed complete recovery of host derived hematopoiesis in the bone marrow, however, mixed T cell chimerism in the peripheral blood. This suggests that the persistence of donor-derived T cells may prevent disease recurrence through graft-versus-leukemia effect. The patient remains in a molecular complete remission with host-derived hematopoiesis 749 days post-transplant.",
keywords = "Allogeneic bone marrow transplantation, Autologous hematopoiesis, Chronic myelogenous leukemia, Graft-versus-leukemia effects, Mixed chimerism, Molecular remission",
author = "Masatoshi Wakui and Shinichiro Okamoto and A. Ishida and Ryuji Tanosaki and Takehiko Mori and Y. Kawai and S. Ohshima and Y. Ikeda",
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journal = "Bone Marrow Transplantation",
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T1 - Durable molecular remission in a patient with chronic myelogenous leukemia and host-derived hematopoiesis after allogeneic bone marrow transplantation

AU - Wakui, Masatoshi

AU - Okamoto, Shinichiro

AU - Ishida, A.

AU - Tanosaki, Ryuji

AU - Mori, Takehiko

AU - Kawai, Y.

AU - Ohshima, S.

AU - Ikeda, Y.

PY - 1996/10

Y1 - 1996/10

N2 - A 44-year-old woman with Ph-positive CML was treated with TBI, splenic irradiation, Ara-C, and CY. She then received unmanipulated marrow cells from her HLA-identical brother. GVHD prophylaxis was FK506 and MTX. WBC counts reached 1000/μl on day 28 when all metaphases of marrow cells showed 46XY. However, on day 42, 46XX was detected in two of 20 metaphases, and the percentage of cells with female karyotype subsequently increased. On day 519, all metaphases showed female karyotype. BCR-ABL mRNA and Philadelphia chromosome were never detected throughout her post-transplant course. Fluorescence in situ hybridization (FISH) revealed complete recovery of host derived hematopoiesis in the bone marrow, however, mixed T cell chimerism in the peripheral blood. This suggests that the persistence of donor-derived T cells may prevent disease recurrence through graft-versus-leukemia effect. The patient remains in a molecular complete remission with host-derived hematopoiesis 749 days post-transplant.

AB - A 44-year-old woman with Ph-positive CML was treated with TBI, splenic irradiation, Ara-C, and CY. She then received unmanipulated marrow cells from her HLA-identical brother. GVHD prophylaxis was FK506 and MTX. WBC counts reached 1000/μl on day 28 when all metaphases of marrow cells showed 46XY. However, on day 42, 46XX was detected in two of 20 metaphases, and the percentage of cells with female karyotype subsequently increased. On day 519, all metaphases showed female karyotype. BCR-ABL mRNA and Philadelphia chromosome were never detected throughout her post-transplant course. Fluorescence in situ hybridization (FISH) revealed complete recovery of host derived hematopoiesis in the bone marrow, however, mixed T cell chimerism in the peripheral blood. This suggests that the persistence of donor-derived T cells may prevent disease recurrence through graft-versus-leukemia effect. The patient remains in a molecular complete remission with host-derived hematopoiesis 749 days post-transplant.

KW - Allogeneic bone marrow transplantation

KW - Autologous hematopoiesis

KW - Chronic myelogenous leukemia

KW - Graft-versus-leukemia effects

KW - Mixed chimerism

KW - Molecular remission

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