[Long-term remission in an acute monoblastic leukemia patient with down syndrome after cord blood transplantation].

Abstract

A 4-year-old boy with Down syndrome (DS) was diagnosed as having acute monoblastic leukemia (AML-M5a). Leukemic cells were CD33+, CD56+ and CD4+, with t(9;11) on cytogenetic analysis and MLL gene rearrangement. After 2 courses of induction therapy using an AML 99-Down protocol failed to obtain complete remission, the patient received cord blood transplantation from an HLA-matched donor (CBT) following a conditioning regimen comprising total body irradiation and cyclophosphamide. Only cyclosporin A was used for graft-versus-host disease prophylaxis. Stem cell transplantation may not be indicated for AML patient with DS in first remission, who display a high rate of life-threatening and fatal toxicity on therapy. This patient remained well controlled in complete remission for 4 years, representing a rare case of DS with chemotherapy-resistant AML successfully treated with a CBT.

• Authors: Hidemitsu Kurosawa, Tatsuo Tsuboi, Hagane Shimaoka, Mayuko Okuya, Daisuke Nakajima, Takayuki Matsunaga, Susumu Hagisawa, Yuya Sato, Kenichi Sugita, Mitsuoki Eguchi
• Journal: [Rinsho ketsueki] The Japanese journal of clinical hematology (Rinsho Ketsueki) Vol. 46 Issue 4 Pg. 274-7 (Apr 2005) ISSN: 0485-1439 [Print] Japan
• PMID: 16444960 (Publication Type: Case Reports, English Abstract, Journal Article)

Chemical References

• Cyclosporine

Topics

• Child, Preschool
• Cord Blood Stem Cell Transplantation
• Cyclosporine (administration & dosage)
• Down Syndrome (complications)
• Graft vs Host Disease (prevention & control)
• Humans
• Leukemia, Monocytic, Acute (diagnosis, genetics, therapy)
• Male
• Remission Induction
• Time Factors
• Transplantation Conditioning
• Treatment Outcome