Bashey A, Shepherd S, Frankel W, Wang-Rodriguez J, Cahill T, Chamberlain M, Mason J R, Ho A D, Corringham R E
Division of Bone Marrow Transplantation, University of California, San Diego, La Jolla 92093-0987, USA 92093-0987, USA.
Oncol Rep. 1998 Jan-Feb;5(1):281-5. doi: 10.3892/or.5.1.281.
Two patients with chronic myeloid leukemia (CML) who relapsed in blastic transformation after allogeneic bone marrow transplantation (BMT) were treated with infusions of leukapheresed peripheral blood mononuclear cells from their original donor. At relapse, their disease was characterized by symptomatic extramedullary deposits of leukemia with minimal (PCR positive, cytologically negative) involvement of bone marrow. Treatment with donor cell infusions was associated with clinical remission, return of full donor chimerism and loss of the BCR-ABL transcript detectable in bone marrow before donor leukocyte infusion (molecular remission). Donor leukocyte infusions should be considered for therapy of relapsed blastic phase CML after allogeneic BMT, especially when the relapse is primarily extramedullary and responsive to local and systemic cytoreductive therapy. However, severe GVHD and CNS relapse remain obstacles to achieving a successful long-term outcome.
两名慢性粒细胞白血病（CML）患者在异基因骨髓移植（BMT）后发生急变期复发，接受了来自其原供者的白细胞单采外周血单个核细胞输注治疗。复发时，他们的疾病特征为有症状的白血病髓外沉积，骨髓受累轻微（PCR阳性，细胞学阴性）。供体细胞输注治疗与临床缓解、完全供者嵌合状态恢复以及供者白细胞输注前在骨髓中可检测到的BCR-ABL转录本消失（分子缓解）相关。对于异基因BMT后复发的急变期CML患者，尤其是当复发主要为髓外且对局部和全身细胞减灭性治疗有反应时，应考虑进行供者白细胞输注。然而，严重的移植物抗宿主病（GVHD）和中枢神经系统复发仍然是实现成功长期预后的障碍。
