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.

  • Correspondence
  • Published:

Reply to Schuster et al

Leukemia volume 19, pages 1275–1276 (2005)Cite this article

TO THE EDITOR

In their comment,1 Schuster et al report on two children suffering from acute myeloid leukemia (AML) relapse after allogeneic stem cell transplantation (SCT), that were treated according to a protocol published in a recent issue of Leukemia.2 Both patients had an unfavorable cytogenetic aberration and had shown delayed response to initial chemotherapy, indicating high-risk disease. SCT from an HLA-identical sibling had been applied as consolidation therapy. No Graft-versus-Host disease (GvHD) occurred, and both patients achieved complete hematological remission (CHR) and negativity for minimal residual disease markers. However, cytogenetic, respectively molecular relapse was detected before day +100, followed by hematological relapse at 6 and 9 months from transplant. Intensive reinduction chemotherapy was given, and adoptive immunotherapy, using mobilized donor peripheral blood stem cells (PBSC), GM-CSF, IL2 and transfusion of unstimulated donor lymphocytes, was applied. No acute GvHD occurred after PBSC. One patient relapsed again at 15 months from treatment and received a second transplant from another donor, whereas the other patient achieved a remission of >2 years.

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

References

  1. Schuster FR, Führer M, Woessmann W, Reiter A, Harbott J, Viehmann S et al. Treatment of relapsed acute myelogenous lekemia with MLL/AF6 fusion after stem cell transplantation by intensive reinduction followed by adoptive immunotherapy. Leukemia 2005, May 5 [E-pub ahead of print].

  2. Schmid C, Schleuning M, Aschan J, Ringdén O, Hahn J, Holler E et al. Low-dose AraC, donor cells, and GM-CSF for treatment of recurrent acute myeloid leukemia after allogeneic stem cell transplantation. Leukemia 2004; 18: 1430–1433.

    Article  CAS  Google Scholar 

  3. Mortimer J, Blinder MA, Schulmann S, Appelbaum FR, Buckner CD, Clift RA et al. Relapse of acute leukemia after marrow transplantation: natural history and results of subsequent therapy. J Clin Oncol 1989; 7: 50–57.

    Article  CAS  Google Scholar 

  4. Heath WR, Carbone FR . Cytotoxic T lymphocyte activation by cross-priming. Curr Opin Immunol 1999; 11: 314–318.

    Article  CAS  Google Scholar 

  5. Sachs L . Control of normal cell differentiation and the phenotypic reversion of malignancy in myeloid leukaemia. Nature 1978; 274: 535–539.

    Article  CAS  Google Scholar 

  6. Kolb HJ, Schmid C, Barret AJ, Schendel D . Graft-versus-leukemia reactions in allogeneic chimeras. Blood 2004; 104: 767–776.

    Google Scholar 

  7. Barrett AJ, Locatelli F, Treleaven JG, Gratwohl A, Szydlo R, Zwaarn FE . Second transplants for leukaemic relapse after bone marrow transplantation: high early mortality but favourable effect of chronic GVHD on continued remission. A report by the EBMT Leukaemia Working Party. Br J Haematol 1991; 79: 567–574.

    Article  CAS  Google Scholar 

  8. Meshinchi S, Leisenring WM, Carpenter PA, Woolfrey AE, Sievers EL, Radich JP et al. Survival after second hematopoietic stem cell transplantation for recurrent pediatric acute myeloid leukemia. Biol Blood Marrow Transplant 2003; 9: 706–713.

    Article  Google Scholar 

  9. Pawson R, Potter NM, Theocharous P, Lawler M, Garg M, Yin JA et al. Treatment of relapse after allogeneic bone marrow transplantation with reduced intensity conditioning (FLAG+/−Ida) and second allogeneic stem cell transplant. Br J Hematol 2001; 115: 622–629.

    Article  CAS  Google Scholar 

  10. Eapen M, Giralt S, Horowitz M, Klein J, Wagner E, Zhang M-J . Second transplant for acute and chronic leukemia after first HLA-identical sibling transplant. Bone Marrow Transplant 2004; 34: 721–727.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Medicine III, José Carreras Unit for Hematopoietic Transplantation, Klinikum der Ludwig Maximilians-Universität München, Munich, Germany

    C Schmid & H-J Kolb

Authors
  1. C Schmid
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. H-J Kolb
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to C Schmid.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Schmid, C., Kolb, HJ. Reply to Schuster et al. Leukemia 19, 1275–1276 (2005). https://doi.org/10.1038/sj.leu.2403792

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.leu.2403792

Search

Advanced search

Quick links