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Spontaneous complete remission and recovery of donor haemopoiesis without GVHD after relapse and apparent marrow graft rejection in poor‐prognosis myelodysplastic syndrome
Author(s) -
Beguin Yves,
Collig Joelle,
Laurent Christian,
Fillet Georges
Publication year - 1996
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1046/j.1365-2141.1996.d01-1824.x
Subject(s) - medicine , myelofibrosis , haematopoiesis , graft versus host disease , lymphoma , spontaneous remission , myelodysplastic syndromes , disease , pneumonia , ganciclovir , gastroenterology , immunology , oncology , bone marrow , surgery , stem cell , pathology , virus , biology , genetics , alternative medicine , human cytomegalovirus
We report a patient with poor‐prognosis myelodysplastic syndrome (MDS) after successful treatment of lymphoma, who was given an allogeneic BMT, engrafted and achieved complete remission, but later had a relapse of his MDS with complete disappearance of donor haemopoiesis. After two episodes of CMV pneumonia and continued prophylactic use of ganciclovir thereafter, he experienced a spontaneous complete disappearance of all signs of MDS, including myelofibrosis, and a complete return to donor haemopoiesis. This case is the first one to suggest a graft‐versus‐leukaemia effect (GVL) in MDS patients. It depicts the complex relationship between GVL, graft‐versus‐host disease (GVHD) and graft rejection. It could also constitute a clinical illustration of the possible antileukaemic effect of CMV infection and its treatment with ganciclovir.