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Allogeneic peripheral stem-cell transplantation with reduced-intensity conditioning regimen in refractory primary B-cell prolymphocytic leukemia: a long-term follow-up

Bone Marrow Transplantation volume 35, page 1225 (2005)Cite this article

In 2001, we reported a case of refractory primary B-cell prolymphocytic leukemia (B-PLL) treated with allogeneic stem-cell transplantation with reduced-intensity conditioning (RIC) fludarabine-based regimen. At that time, complete remission (CR) was confirmed at almost 1 year after transplantation.1

Since that time, the clinical course has been marked by two immunological complications. In April 2001, warm-antibody hemolytic anemia was diagnosed and treated with steroids leading to a CR. In January 2002, the patient was hospitalized because of clinically symptomatic idiopathic thrombocytopenia, resistant to immunoglobulin and steroids. Consequently, the patient underwent splenectomy with full and durable recovery of platelets. Histological examination of spleen did not show pathological prolymphocytes, confirming a CR status. The occurrence of autoimmune cytopenia following several months from transplantation is of particular interest. We did not identify any precipitating factors, such as infection or drugs, before either episode. It has been hypothesized that, in a context of ABO and other alloantigen differences, the persistence of recipient immunoglobulin and hematopoietic cells could explain immune reactions.2 However, in this case, the donor/recipient pair was matched for ABO and other alloantigen systems, excluding this hypothesis. Therefore, more complex phenomena were likely, including a break in peripheral tolerance.

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References

  1. Castagna L, Nozza A, Bertuzzi A et al. Allogeneic peripheral blood stem cell transplantation with reduced intensity conditioning in primary refractory prolymphocytic leukemia: graft-versus-leukemia effect without graft-versus-host disease. Bone Marrow Transplant 2001; 28: 1155–1156.

    Article  CAS  Google Scholar 

  2. Klumpp TR . Immunohematologic complications of bone marrow transplantation. Bone Marrow Transplant 1991; 8: 159–170.

    CAS  Google Scholar 

  3. Faulkner RD, Craddock C, Byrne JL et al. BEAM-alemtuzumab reduced-intensity allogeneic stem cell transplantation for lymphoproliferative diseases: GVHD, toxicity, and survival in 65 patients. Blood 2004; 103: 428–434.

    Article  CAS  Google Scholar 

  4. Schetelig J, Thiede C, Bornhauser M et al. Evidence of a graft-versus-leukemia effect in chronic lymphocytic leukemia after reduced-intensity conditioning and allogeneic stem-cell transplantation: the Cooperative German Transplant Study Group. J Clin Oncol 2003; 21: 2747–2753.

    Article  CAS  Google Scholar 

  5. Khouri IF, Lee MS, Saliba RM et al. Nonablative allogeneic stem cell transplantation for chronic lymphocytic leukemia: impact of rituximab on immunomodulation and survival. Exp Hematol 2004; 32: 28–35.

    Article  CAS  Google Scholar 

  6. Dreger P, Brand R, Hansz J et al. Treatment-related mortality and graft-versus-leukemia activity after allogeneic stem cell transplantation for chronic lymphocytic leukemia using intensity-reduced conditioning. Leukemia 2003; 17: 841–848.

    Article  CAS  Google Scholar 

  7. McSweeney PA, Niederwieser D, Shizuru JA et al. Hematopoietic cell transplantation in older patients with hematologic malignancies: replacing high-dose cytotoxic therapy with graft-versus-tumor effects. Blood 2001; 97: 3390–3400.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Medical Oncology and Hematology, Istituto Clinico Humanitas, via Manzoni 56, Rozzano, Milan, Italy

    L Castagna, B Sarina, E Todisco, R Mazza & A Santoro

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  1. L Castagna
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  2. B Sarina
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  3. E Todisco
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  4. R Mazza
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Castagna, L., Sarina, B., Todisco, E. et al. Allogeneic peripheral stem-cell transplantation with reduced-intensity conditioning regimen in refractory primary B-cell prolymphocytic leukemia: a long-term follow-up. Bone Marrow Transplant 35, 1225 (2005). https://doi.org/10.1038/sj.bmt.1704991

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