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Relapse of Philadelphia chromosome positive acute lymphoblastic leukaemia after marrow transplantation: sustained molecular remission after early and dose‐escalating infusion of donor leucocytes
Author(s) -
Keil Felix,
Kalhs Peter,
Haas Oskar A.,
Fritsch Gerhard,
Reiter Elisabeth,
Mannhalter Christine,
Lechner Klaus,
Leitner Gerda,
Greinix Hildegard T.
Publication year - 1997
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.1365-2141.1997.262674.x
Subject(s) - medicine , philadelphia chromosome , bone marrow , acute lymphocytic leukemia , transplantation , immunology , sepsis , leukemia , gastroenterology , lymphoblastic leukemia , chromosomal translocation , biology , biochemistry , gene
We present a patient who underwent sibling allogeneic BMT because of refractory Ph+ve ALL and remained BCR‐ABL‐positive after marrow grafting. Haemopoietic precursor cells were predominantly BCR‐ABL‐negative and of donor origin. In T cells an exclusively donor genotype was demonstrated. Despite donor leucocyte infusion (DLI), 20 weeks after BMT BCR‐ABL fusion mRNA increased in semiquantitative polymerase chain reaction and leukaemic infiltration of the patient's bone marrow was seen. After a second course of DLI the patient achieved sustained molecular remission but he developed severe graft‐versus‐host disease (GvHD) and died from bacterial sepsis 9 months after DLI.