[Graft-versus-ATLL effect induced by abrupt discontinuation of immunosuppression following allogeneic bone marrow transplantation].

Abstract

A 46-year-old man was admitted to our hospital with swelling of a neck lymph node in June, 2002, and was diagnosed with adult T-cell leukemia/lymphoma (ATLL). As ATLL cells were detected in the peripheral blood after two courses of multi-agent chemotherapy (LSG 15), the treatment was changed to biweekly CHOP therapy. After two courses, hematological remission was achieved. Allogeneic bone marrow transplant (allo-BMT) from HTLV- negative and HLA-matched sibling donor was performed (conditioned with cyclophosphamide 60 mg/kg x 2 and total body irradiation 12 Gy). Cyclosporine A (CsA) and short-term methotrexate (MTX) were used for graft-versus-host disease prevention. Though the HTLV- provirus DNA (Southern blot) disappeared, HTLV-I provirus DNA (real-time PCR) T-cell receptor ygammachain gene rearrangement DNA (Southern blot) were detected in bone marrow after allo-BMT. MRD disappeared after the withdrawal of CsA. After the allo-BMT transplant, a graft-versus-ATLL (GVATLL) effect may be induced by abrupt discontinuation of immunosuppression.

• Authors: Satoshi Hara, Taiji Yokote, Tomokazu Akioka, Satoshi Oka, Tsuyoshi Yamano, Motomu Tsuji, Toshiaki Hanafusa
• Journal: Gan to kagaku ryoho. Cancer & chemotherapy (Gan To Kagaku Ryoho) Vol. 32 Issue 6 Pg. 867-71 (Jun 2005) ISSN: 0385-0684 [Print] Japan
• PMID: 15984534 (Publication Type: Case Reports, Journal Article)

Chemical References

• DNA, Viral
• Vincristine
• Doxorubicin
• Cyclosporine
• Cyclophosphamide
• Prednisone
• Methotrexate

Topics

• Antineoplastic Combined Chemotherapy Protocols (administration & dosage, therapeutic use)
• Bone Marrow Transplantation
• Cyclophosphamide (administration & dosage)
• Cyclosporine (administration & dosage)
• DNA, Viral (analysis)
• Doxorubicin (administration & dosage)
• Graft vs Leukemia Effect
• Human T-lymphotropic virus 1 (genetics)
• Humans
• Immunosuppression Therapy
• Leukemia-Lymphoma, Adult T-Cell (drug therapy, pathology, therapy)
• Male
• Methotrexate (administration & dosage)
• Middle Aged
• Neoplasm, Residual
• Prednisone (administration & dosage)
• Remission Induction
• Vincristine (administration & dosage)