Fukumoto Y, Tanizawa A, Takeuchi M, Takano T, Kikawa Y, Sudo M
Department of Pediatrics, Fukui Medical School.
Rinsho Ketsueki. 1995 Oct;36(10):1204-9.
We report a 3-year-old boy with acute myelogenous leukemia, who relapsed very early after peripheral blood stem cell transplantation (PBSCT). He was admitted with a tumor in maxillar sinus and hemorrhagic diathesis and was diagnosed as having acute myelogenous leukemia with t(8;21). He achieved complete remission with etoposide, cytosine arabinoside and mitoxantrone. After 8 courses of consolidation therapy and marrow ablative chemotherapy, he received PBSCT. G-CSF was given from day 0 because of severe infection. WBC and platelete counts rapidly increased, however, from day 20 platelet count spontaneously decreased. Concomitantly bone marrow examination revealed the presence of blastic cells. RT-PCR showed that the presence of AML 1/MTG 8 chimera mRNA in the cryopreserved PBSC samples. In vitro analysis also revealed that leukemic cells had G-CSF receptors and increased 3H-thymidine uptake in the presence of G-CSF. These findings strongly suggest that the reinfusion of leukemic cells in PBSC and the administration of G-CSF after PBSCT might be relevant to early relapse in this patient.
我们报告了一名3岁患急性髓性白血病的男孩，他在接受外周血干细胞移植（PBSCT）后很早便复发了。他因上颌窦肿瘤和出血素质入院，被诊断为患有t(8;21)急性髓性白血病。他通过依托泊苷、阿糖胞苷和米托蒽醌实现了完全缓解。在进行8个疗程的巩固治疗和骨髓清除化疗后，他接受了PBSCT。由于严重感染，从第0天开始给予粒细胞集落刺激因子（G-CSF）。白细胞和血小板计数迅速增加，然而，从第20天起血小板计数自发下降。同时骨髓检查发现有原始细胞存在。逆转录聚合酶链反应（RT-PCR）显示在冷冻保存的外周血干细胞样本中存在AML 1/MTG 8嵌合mRNA。体外分析还显示白血病细胞具有G-CSF受体，并且在有G-CSF存在的情况下3H-胸腺嘧啶核苷摄取增加。这些发现强烈提示外周血干细胞中白血病细胞的回输以及PBSCT后G-CSF的使用可能与该患者的早期复发有关。
