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Lymphodepletion chemotherapy followed by donor leukocytes for post‐transplantation relapse of myelofibrosis after previous donor leukocyte infusion failure
Author(s) -
Neave Emma Lucy,
Schwarb Heike,
Shlebak Abdurrazag,
Layton David Mark,
Apperley Jane F.,
Pavlu Jiri
Publication year - 2013
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/ejh.12034
Subject(s) - myelofibrosis , medicine , chemotherapy , transplantation , cyclophosphamide , surgery , immunology , bone marrow
Treatment of relapse after allogenic stem cell transplantation (allo‐ SCT ) is challenging. The efficacy of donor leukocyte infusions ( DLI ) is excellent in chronic phase chronic myeloid leukaemia but limited in other disorders. We present a patient who relapsed 10 months after reduced intensity conditioning allo‐ SCT for a myelodysplastic/ myeloproliferative neoplasm with myelofibrosis despite receiving escalating doses of DLI for incomplete chimerism. He finally achieved complete remission with full whole blood and T‐cell donor chimerism after DLI preceded by lymphodepletion chemotherapy. This case demonstrates that chemotherapy prior to DLI is a useful approach for treating relapses of relatively slowly progressive diseases, such as myeloproliferative diseases or myelodysplastic syndromes.