Donor leukocyte transfusions and discontinuation of immunosuppressants to achieve an initial remission after allogeneic bone marrow transplantation in a patient with primary refractory acute leukemia.

Abstract	We present a female patient who received an allogeneic bone marrow transplantation for primary refractory Philadelphia-positive acute biphenotypic leukemia. Since leukemic blasts were persistently present in peripheral blood and bone marrow, in spite of the evidence for engraftment of male donor hematopoiesis, we performed donor leukocyte transfusions and discontinued immunosuppression. An initial complete remission was obtained 15 weeks after allogeneic bone marrow transplantation, and lasted for 24 weeks. We concluded that the prominent mechanism for the eradication of the refractory leukemic clone in the patient was the graft-versus-leukemia effect.
Authors	Y Azuno, T Kaneko, M Nishimura, S Okuya, K Nakai, J Nomiyama, K Mori, K Okafuji, M Okubo, A Matsutani, S Kamei, Y Zaitsu, Y Takeuchi, Y Oka, K Kaku
Journal	Bone marrow transplantation (Bone Marrow Transplant) Vol. 18 Issue 1 Pg. 257-9 (Jul 1996) ISSN: 0268-3369 [Print] England
PMID	8832032 (Publication Type: Case Reports, Journal Article)
Chemical References	Immunosuppressive Agents Prednisolone Methylprednisolone
Topics	Adult Antineoplastic Combined Chemotherapy Protocols (therapeutic use) Bone Marrow (pathology) Bone Marrow Transplantation (immunology) Clone Cells (immunology, pathology) Combined Modality Therapy Drug Resistance, Neoplasm Fatal Outcome Female Graft vs Host Disease (drug therapy, etiology) Graft vs Host Reaction Humans Immunosuppressive Agents (administration & dosage, adverse effects) Leukocyte Transfusion Male Methylprednisolone (administration & dosage, adverse effects) Neoplastic Cells, Circulating Neoplastic Stem Cells (immunology, pathology) Precursor Cell Lymphoblastic Leukemia-Lymphoma (blood, pathology, therapy) Prednisolone (administration & dosage, adverse effects) Recurrence Remission Induction Tissue Donors Transplantation, Homologous

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