Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Case Report
  • Published:

Atypical chronic graft-versus-host disease following interferon therapy for chronic myeloid leukaemia relapsing after allogeneic BMT

Abstract

We report a 54-year-old woman who received interferon alpha for haematological relapse of Ph-positive CML, 7 years after allogeneic BMT from an HLA-identical brother. Eighteen months after relapse, cytogenetic and molecular remission was achieved. She received interferon therapy for 25 months and it was discontinued when she developed skin lesions on her face and trunk, dysphagia and fever with respiratory failure and bilateral patchy airspace consolidation of the lung without microbiologic findings. Histologic features showed discoid lupus erythematosis, oesophagitis with pseudomembranes and a mixed pattern of lymphocytic bronchiolitis involving the alveoli and interstitial spaces all compatible with chronic GVHD. The patient was commenced on immunosuppressive therapy with complete clinical and radiological resolution. The available evidence supports an atypical presentation of chronic GVHD and suggests a role for interferon alpha in the pathogenesis of GVHD. To the best of our knowledge, this is the first case reported of severe chronic GVHD occurring during the course of interferon therapy for relapsed CML. Bone Marrow Transplantation (2001) 27, 85–87.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  1. Kolb HJ, Schatterberg A, Goldman JM et al. Graft-versus leukemia effect of donor lymphocyte transfusions in marrow grafted patients Blood 1995 86: 2041–2050

    CAS  PubMed  Google Scholar 

  2. Mackinnon S, Papadopoulos EB, Carabasi MH et al. Adoptive immunotherapy evaluating escalating doses of donor leukocytes for relapse of chronic myeloid leukemia after bone marrow transplantation: separation of graft-versus-leukemia responses from graft-versus-host disease Blood 1995 86: 1261–1268

    CAS  PubMed  Google Scholar 

  3. Bacigalupo A, Soraco M, Vassalto F et al. Donor lymphocyte infusions in patients with chronic myeloid leukemia following allogeneic bone marrow transplantation Bone Marrow Transplant 1997 19: 927–932

    Article  CAS  PubMed  Google Scholar 

  4. Arcese W, Goldman JM, D'Arcangelo E et al. Outcome for patients who relapse after allogeneic bone marrow transplantation for chronic myeloid leukemia Blood 1993 82: 3211–3219

    CAS  PubMed  Google Scholar 

  5. Higano CS, Chielens D, Raskind W et al. Use of alpha-2a-interferon to treat cytogenetic relapse of chronic myeloid leukemia after marrow transplantation Blood 1997 90: 2549–2554

    CAS  PubMed  Google Scholar 

  6. Steegmann JL, Casado LF, Tomas JF et al. Interferon alpha for chronic myeloid leukemia relapsing after allogeneic bone marrow transplantation Bone Marrow Transplant 1999 23: 483–488

    Article  CAS  PubMed  Google Scholar 

  7. Shulman HM, Sullivan KM, Weiden PL et al. Chronic graft-versus-host syndrome in man. A long-term clinicopathologic study of 20 Seattle patients Am J Med 1980 69: 204–217

    Article  CAS  PubMed  Google Scholar 

  8. Sánchez J, Torres A, Serrano J et al. Long-term follow-up of immunosuppressive treatment for obstructive airways disease after allogeneic bone marrow transplantation Bone Marrrow Transplant 1997 20: 403–408

    Article  Google Scholar 

  9. Beard JS, Smith KL, Skelton HG . Combination chemotherapy with 5-fluorouracil, folinic acid and alpha-interferon producing histological features of graft-versus-host disease J Am Acad Dermatol 1993 29: 325–330

    Article  CAS  PubMed  Google Scholar 

  10. Cyclosporin A/alpha interferon-induced autologous graft-versus-host disease following peripheral blood stem cell transplantation for chronic myeloid leukemia: a clinico-pathological study Bone Marrow Transplant 1997 20: 83–85

    Article  CAS  PubMed  Google Scholar 

  11. Pavord S, Sivakumaran M, Durrant S, Chapman C . The role of alpha interferon in the pathogenesis of GVHD Bone Marrow Transplant 1992 10: 477

    CAS  PubMed  Google Scholar 

  12. Browett PJ, Nelson J, Tiwari S et al. Graft-versus-host disease following interferon therapy for relapsed chronic myeloid leukemia post-allogeneic bone marrow transplantation Bone Marrow Transplant 1994 24: 641–644

    Google Scholar 

  13. Metha J, Powles R, Kulkarni S et al. Induction of graft-versus-host disease as immunotherapy of leukemia relapsing after allogeneic transplantation: single-center experience of 32 adult patients Bone Marrow Transplant 1997 20: 129–135

    Article  Google Scholar 

  14. Klingemann HG, Grigg AP, Wilkie-Boyd K et al. Treatment with recombinant interferon (α-2b) early after bone marrow transplantation in patients at high risk for relapse Blood 1991 78: 3306–3311

    CAS  PubMed  Google Scholar 

  15. Okanoue T, Sakamoto S, Itoh Y et al. Side effects of high-dose interferon therapy for chronic hepatitis C J Hepatol 1996 25: 283–291

    Article  CAS  PubMed  Google Scholar 

  16. Skoskiewicz MG, Colvin RB, Schneerburger EE, Russell PS . Histocompatibility complex-determined antigens in vivo by gamma interferon J Exp Med 1985 162: 1645–1664

    Article  CAS  PubMed  Google Scholar 

  17. Ghayur T, Seemayer TA, Kongshavn PA et al. Graft versus host reactions in the beige mouse. An investigation of the role of host and donor natural killer cells in the pathogenesis of graft-versus-host disease Transplantation 1987 44: 261–267

    Article  CAS  PubMed  Google Scholar 

  18. Reyes VE, Klimpel GR . Interferon alpha/beta synthesis during acute graft versus host disease Transplantation 1987 43: 412–416

    Article  CAS  PubMed  Google Scholar 

  19. Cleveland MG, Lane RG, Klimpel GR . Enhaced interferon alpha/beta and defective interferon gamma production in chronic graft-versus-host disease: a potential mechanism for immunosuppression Cell Immunol 1987 110: 120–130

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Serrano, J., Prieto, E., Mazarbeitia, F. et al. Atypical chronic graft-versus-host disease following interferon therapy for chronic myeloid leukaemia relapsing after allogeneic BMT. Bone Marrow Transplant 27, 85–87 (2001). https://doi.org/10.1038/sj.bmt.1702746

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.bmt.1702746

Keywords

This article is cited by

Search

Quick links