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:

Successful treatment of bcr/abl-positive acute mixed lineage leukemia by unmanipulated bone marrow transplantation from an HLA-haploidentical (3-antigen-mismatched) cousin

Bone Marrow Transplantation volume 31, pages 1165–1168 (2003)Cite this article

Summary:

We describe a patient with bcr/abl-positive acute mixed lineage leukemia who successfully underwent transplantation in primary induction failure, using unmanipulated bone marrow from a human leukocyte antigen (HLA)-haploidentical cousin. The tumor burden was successfully reduced by the administration of imatinib mesylate (STI571) before transplantation. As graft-versus-host disease (GVHD) prophylaxis, a combination of tacrolimus and a short course of methotrexate, methylprednisolone, and mycophenolate mofetil was used. Hematopoietic reconstitution was rapid, and acute GVHD was limited to the skin (grade I). The patient is still in complete remission past day +400. This successful case suggests that HLA-haploidentical transplantation using unmanipulated marrow from a distantly related relative can be considered for patients in urgent situations who do not have HLA-identical donors.

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

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

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

Figure 1
Figure 2

Similar content being viewed by others

References

  1. Henslee-Downey PJ, Abhyankar SH, Parrish RS et al. Use of partially mismatched related donors extends access to allogeneic marrow transplant. Blood 1997; 89: 3864–3872.

    CAS  PubMed  Google Scholar 

  2. Aversa F, Tabilio F, Velardi A et al. Treatment of high-risk acute leukemia with T-cell-depleted cells from related donors with one fully mismatched HLA haplotype. N Engl J Med 1998; 339: 1186–1193.

    Article  CAS  PubMed  Google Scholar 

  3. Marmont A, Horowitz M, Gale R et al. T-cell depletion of HLA-identical transplants in leukemia. Blood 1991; 78: 2120–2130.

    CAS  PubMed  Google Scholar 

  4. Ogawa H, Soma T, Hosen N et al. Combination of tacrolimus, methotrexate, and methylprednisolone prevents acute but not chronic graft-versus-host disease in unrelated bone marrow transplantation. Transplantation 2002; 74: 236–243.

    Article  CAS  PubMed  Google Scholar 

  5. Ikegame K, Tanji Y, Kitai N et al. Successful treatment of refractory T cell acute lymphoblastic leukemia by the unmanupulated stem cell transplantation from an HLA 3 loci mismatched (haploidentical) sibling. Bone Marrow Transplant (in press).

  6. Ogawa H, Tsuboi A, Oji Y et al. Successful donor leukocyte transfusion at molecular relapse for a patient with acute myeloid leukemia who was treated with allogeneic bone marrow transplantation: importance of the monitoring of minimal residual disease by WT1 assay. Bone Marrow Transplant 1998; 21: 525–527.

    Article  CAS  PubMed  Google Scholar 

  7. Barrett AJ, Horowitz MM, Pollock BH et al. Bone marrow transplantation for Philadelphia chromosome positive acute lymphoblastic leukemia. Blood 1992; 79: 3067–3070.

    CAS  PubMed  Google Scholar 

  8. Singhal S, Powles R, Henslee-Downey PJ et al. Allogeneic transplantation from HLA-matched sibling or partially HLA-mismatched related donors for primary refractory acute leukemia. Bone Marrow Transplant 2002; 29: 291–295.

    Article  CAS  PubMed  Google Scholar 

  9. Ottmann OG, Druker BJ, Sawyers CL et al. A phase 2 study of imatinib in patients with relapsed or refractory Philadelphia chromosome-positive acute lymphoid leukemias. Blood 2002; 100: 1965–1971.

    Article  CAS  PubMed  Google Scholar 

  10. Guinan EC, Boussiotis VA, Neuberg D et al. Transplantation of anergic histoincompatible bone marrow allografts. N Engl J Med 1999; 340: 1704–1714.

    Article  CAS  PubMed  Google Scholar 

  11. Burlingham W, Railer A, Heisey D et al. The effect of tolerance to noninherited maternal HLA antigens on the survival of renal transplantation sibling donors. N Engl J Med 1998; 339: 1657–1664.

    Article  CAS  PubMed  Google Scholar 

  12. Oh H, Zhang M-J, Akiyama H et al. Comparison of graft-versus-host disease (GVHD) and survival in different ethnic populations: collaborative study by the Japan Adult Leukemia Study Group (JALSG) and the International Bone Marrow Transplant Registry (IBMTR). Blood 2002; 100: 418 (Abstract 1621).

    Google Scholar 

  13. Morishima Y, Morishita Y, Tanimoto M et al. Low incidence of acute graft-versus-host disease by the administration of methotrexate and cyclosporine in Japanese leukemia patients after bone marrow transplantation from human leukocyte antigen compatible siblings; possible role of genetic homogeneity. The Nagoya Bone Marrow Transplantation Group. Blood 1989; 74: 2252–2256.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Molecular Medicine, Osaka University Graduate School of Medicine, Suita city, Osaka, Japan

    K Ikegame, C Mukouchi, M Kawakami, S Nishida, Y Taniguchi, T Fujioka, T Masuda, M Murakami, N Hosen, E H Kim, A Tsuboi, Y Oka, I Kawase & H Ogawa

  2. Division of Hematology and Rheumatology, Department of Medicine, Kitano Hospital, The Tazuke Kofukai Medical Research Institute, Japan

    A Kunitomi & Y Konaka

  3. Department of Clinical Laboratory Science, Osaka University Medical School, Osaka, Japan

    Y Oji & H Sugiyama

Authors
  1. K Ikegame
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. C Mukouchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A Kunitomi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Y Konaka
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. M Kawakami
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. S Nishida
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Y Taniguchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. T Fujioka
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. T Masuda
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. M Murakami
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. N Hosen
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. E H Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. A Tsuboi
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Y Oji
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Y Oka
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. H Sugiyama
    View author publications

    You can also search for this author in PubMed Google Scholar

  17. I Kawase
    View author publications

    You can also search for this author in PubMed Google Scholar

  18. H Ogawa
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ikegame, K., Mukouchi, C., Kunitomi, A. et al. Successful treatment of bcr/abl-positive acute mixed lineage leukemia by unmanipulated bone marrow transplantation from an HLA-haploidentical (3-antigen-mismatched) cousin. Bone Marrow Transplant 31, 1165–1168 (2003). https://doi.org/10.1038/sj.bmt.1704064

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.bmt.1704064

Keywords

This article is cited by

Search

Advanced search

Quick links