Abstract |
Bone marrow (BM) transplantation (BMT) is one of the treatment strategies for congenital metabolic disease, but leukemia secondary to intensive cytoreductive treatment is a major concern. Besides BM cells, mesenchymal stem cells (MSC) are also used for transplantation. An 8-month-old girl with hypophosphatasia underwent transplantation of haploidentical BM cells followed by two transplants of MSC obtained from her father to facilitate osteogenesis. Fludarabine(Flu)/ cyclophosphamide (CPA)/ anti-thymocyte globulin were used for myeloablative conditioning, but the patient developed therapy-related leukemia harboring t(9;22)(q34;q11.2); minor BCR-ABL (t- leukemia with Ph) at the age of 32 months. At the age of 40 months she underwent a second BM and third MSC transplant from the same donor. Thereafter, she achieved complete histological and molecular remission. The present case suggests that the combination of cytotoxic agents (Flu/CPA) and MSC led to t- leukemia with Ph as a consequence of chromosome instability and suppression of host anti- tumor immunity.
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Authors | Takeshi Taketani, Rie Kanai, Mariko Abe, Seiji Mishima, Mika Tadokoro, Yoshihiro Katsube, Shunsuke Yuba, Hajime Ogushi, Seiji Fukuda, Seiji Yamaguchi |
Journal | Pediatrics international : official journal of the Japan Pediatric Society
(Pediatr Int)
Vol. 55
Issue 3
Pg. e52-5
(Jun 2013)
ISSN: 1442-200X [Electronic] Australia |
PMID | 23782379
(Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | © 2013 The Authors. Pediatrics International © 2013 Japan Pediatric Society. |
Chemical References |
- Myeloablative Agonists
- Cyclophosphamide
- Vidarabine
- fludarabine
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Topics |
- Bone Marrow Purging
(adverse effects)
- Bone Marrow Transplantation
(adverse effects)
- Child, Preschool
- Cyclophosphamide
(administration & dosage, adverse effects)
- Female
- Follow-Up Studies
- Humans
- Hypophosphatasia
(therapy)
- Infant
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive
(diagnosis, etiology, genetics)
- Mesenchymal Stem Cell Transplantation
(adverse effects)
- Myeloablative Agonists
(administration & dosage, adverse effects)
- Retreatment
- Vidarabine
(administration & dosage, adverse effects, analogs & derivatives)
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