PMID: 12774933May 31, 2003Paper

Rapid improvement of disseminated intravascular coagulation by donor leukocyte infusions in a patient with promyelocytic crisis of chronic myelogenous leukemia after reduced-intensity stem cell transplantation from an HLA 2-antigen-mismatched mother

International Journal of Hematology
K MatsueT Tabayashi

Abstract

Donor leukocyte infusion (DLI) is recognized as effective therapy for relapse after stem cell transplantation in patients with chronic myelogenous leukemia (CML). However, the clinical efficacy of DLI in the advanced phase of CML or other types of leukemia has not been clearly defined because of its varying degree of success. We describe a 22-year-old male patient with promyelocytic crisis of CML who had a relapse after peripheral blood stem cell transplantation, under reduced-intensity conditioning, from his HLA 2-antigen-mismatched mother. Complete hematologic remission was obtained after transplantation. However, a relapse that occurred on day 66 posttransplantion was characterized by an increase in number of leukemic promyelocytes with simultaneous exacerbation of disseminated intravascular coagulation (DIC). The patient received DLI containing 1 x 10(7)/kg CD3+ cells on day 73. Because rapid improvement of DIC paralleled the decrease in leukemic cells and because it was observed soon after DLI and before the development of acute graft-versus-host disease (GVHD), we hypothesized that leukemia-specific cells other than natural killer cells or cytotoxic T-cells unrelated to GVHD played a role in the graft-versus-leukemia effe...Continue Reading

References

Feb 1, 1997·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·R H CollinsJ Nemunaitis
Nov 22, 1997·Current Opinion in Immunology·A Moretta, L Moretta
Sep 26, 2001·Bone Marrow Transplantation·S TamakiUNKNOWN Japan Society of Hematopoietic Cell Transplantation
Oct 18, 2001·Current Opinion in Hematology·L RuggeriA Velardi

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