Biondi A, Norman C, Messner H A, Minden M D
Mario Negri Institute, Milan, Italy.
Bone Marrow Transplant. 1989 Nov;4(6):705-9.
Despite aggressive therapy for leukemia in the form of bone marrow transplantation (BMT) relapse occurs in a significant number of cases. The origin of the leukemic relapse, whether it is of donor or recipient origin, and how best to treat the patients continue to pose problems for the clinician. In this paper we present a case in which the cytogenetics suggested that the relapse was of donor origin; however, molecular analysis revealed that the leukemic population was of host origin. The leukemic relapse following the BMT was treated with a second BMT. This resulted in a remission of 28 months after which leukemic relapse was again diagnosed. Using conventional chemotherapy it was possible to obtain another complete remission. This case illustrates a pitfall to cytogenetic analysis and two contrasting methods of dealing with leukemic relapse following BMT.
尽管采用了骨髓移植（BMT）这种积极的白血病治疗方法，但仍有相当数量的病例出现复发。白血病复发的起源，无论是供体来源还是受体来源，以及如何最好地治疗患者，仍然是临床医生面临的难题。在本文中，我们介绍了一个病例，其中细胞遗传学提示复发是供体来源；然而，分子分析显示白血病细胞群是宿主来源。BMT后的白血病复发采用第二次BMT进行治疗。这导致了28个月的缓解期，之后再次诊断出白血病复发。使用传统化疗有可能再次获得完全缓解。这个病例说明了细胞遗传学分析的一个陷阱以及两种处理BMT后白血病复发的截然不同的方法。
