Sustained molecular remission in a patient with CML in blastic crisis receiving dose‐reduced hematopoietic stem‐cell transplantation followed by early withdrawal of cyclosporine and prophylactic use of interferon‐α
A 54‐year‐old man with chronic myelocytic leukemia in blastic phase received reduced‐intensity transplantation (RIST) from an HLA‐identical unrelated donor. The preparative regimen consisted of busulfan, fludarabine, and anti‐thymocyte globulin. Graft‐versus‐host disease (GVHD) prophylaxis was cyclo...
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Veröffentlicht in: | American journal of hematology 2002-11, Vol.71 (3), p.196-199 |
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Zusammenfassung: | A 54‐year‐old man with chronic myelocytic leukemia in blastic phase received reduced‐intensity transplantation (RIST) from an HLA‐identical unrelated donor. The preparative regimen consisted of busulfan, fludarabine, and anti‐thymocyte globulin. Graft‐versus‐host disease (GVHD) prophylaxis was cyclosporine alone. Because he had a high risk of relapse, we discontinued cyclosporine on day 37, but he did not develop any signs of acute GVHD. To induce GVHD and augment a graft‐versus‐leukemia effect, we initiated interferon‐α therapy on day 80 to a maximum dosage of three million units five times a week. He achieved molecular remission on day 94 followed by the development of extensive chronic GVHD the severity of which paralleled to the dose of interferon‐α GVHD gradually subsided after discontinuation of interferon‐α and the patient remains in molecular remission 18 months after transplantation. This case suggests that early withdrawal of cyclosporine and the prophylactic use of interferon‐α are promising in RIST for high‐risk leukemia. Am. J. Hematol. 71:196–199, 2002. © 2002 Wiley‐Liss, Inc. |
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ISSN: | 0361-8609 1096-8652 |
DOI: | 10.1002/ajh.10203 |