[Sustained remission of MDS overt leukemia associated with abrupt discontinuation of immunosuppression following relapse after the second course of allogeneic hematopoietic stem cell transplantation].

Abstract

The case of a 32-year-old female with relapsed myelodysplastic syndrome (MDS) after second course of allogeneic transplantation is described. The peripheral blood stem cell transplantation was performed as early as 3 months after the initial bone marrow transplantation because of rejection and relapse; however, the patient again relapsed 2 months later. Immediate discontinuation of cyclosporine resulted in the progression of pancytopenia and the development of high fever, liver dysfunction and skin eruption. The patient was then treated with dexamethasone, which successfully stabilized these symptoms. After these clinical events, a dramatic hematological response was obtained; the blast rate was reduced from 10.6 to 0% in bone marrow aspiration, and pancytopenia was restored to normal levels. Moreover, fluorescence in situ hybridization analyses with X and Y chromosome-specific probes revealed that hematopoietic precursor cells were predominantly of donor origin. The patient subsequently received donor lymphocyte infusion (DLI) from the original donor. Currently, 2 years after DLI, the patient continues to be in remission.

• Authors: Kazuteru Ohashi, Michiaki Mikoshiba, Yuji Tanaka, Yoshiki Okuyama, Kiyoshi Hiruma, Hideki Akiyama, Hisashi Sakamaki
• Journal: [Rinsho ketsueki] The Japanese journal of clinical hematology (Rinsho Ketsueki) Vol. 44 Issue 11 Pg. 1085-9 (Nov 2003) ISSN: 0485-1439 [Print] Japan
• PMID: 14689872 (Publication Type: Case Reports, English Abstract, Journal Article)

Chemical References

• Cyclosporine

Topics

• Adult
• Cyclosporine (administration & dosage)
• Female
• Humans
• Leukemia (therapy)
• Myelodysplastic Syndromes (therapy)
• Peripheral Blood Stem Cell Transplantation