scholarly journals Daunorubicin, Cytarabine, and Cladribine Regimen Plus Radiotherapy and Donor Lymphocyte Infusion for Extramedullary Relapse of Acute Myeloid Leukemia after Hematopoietic Stem Cell Transplantation

2013 ◽  
Vol 2013 ◽  
pp. 1-2
Author(s):  
Marco Sanna ◽  
Giovanni Caocci ◽  
Adriana Vacca ◽  
Eugenia Piras ◽  
Federica Orrù ◽  
...  
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Myeloid Leukemia ◽  
Donor Lymphocyte Infusion ◽  
Hematopoietic Stem ◽  
First Case ◽  
Extramedullary Relapse

Myeloid sarcoma is a rare tumor consisting of myeloid blasts that involve anatomic sites outside the bone marrow. Fatal prognosis is inevitable in patients with extramedullary relapse after hematopoietic stem cell transplantation (HSCT), and no standard treatments are available yet. We report the first case of extramedullary relapse after HSCT treated with a combination of daunorubicin, cytarabine, and cladribine (DAC) regimen plus radiotherapy and donor lymphocyte infusion (DLI). This treatment induced a new and durable remission in our patient. The favorable toxicity profile and the reduced cost make this combination worthy of further investigations.

Effective Treatment with Imatinib Mesylate and Donor Lymphocyte Infusion Following Relapse after Allogeneic Hematopoietic Stem Cell Transplantation for Chronic Myeloid Leukemia.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 5419-5419
Author(s):  
Jianyong Li ◽  
Hanxin Wu ◽  
Sixuan Qian ◽  
Ming Hong ◽  
Bing Xiao ◽  
...  
Keyword(s):  
Stem Cell ◽  
Chronic Myeloid Leukemia ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Imatinib Mesylate ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Myeloid Leukemia ◽  
Donor Lymphocyte Infusion ◽  
Hematopoietic Stem

Abstract Imatinib mesylate (STI571) and donor lymphocyte infusion (DLI) were two most effective treatment for chronic myeloid leukemia (CML) relapsed after allogeneic hematopoietic stem cell transplantation (allo-HSCT). However, the combination of STI571 and DLI was rarely reported in the treatment of CML relapse after allo-HSCT. To explore the effect of STI571 with DLI in the treatment of relapse after allogeneic hematopoietic stem cell transplantation (allo-HSCT) for CML, two relapsed CML patients after allo-HSCT were treated with short course (<1 month) of STI571 400 mg or 600 mg/d and DLI. Case 1, female, 32 years old (yrs), transformed to acute myeloid leukemia (AML) M2 four months after diagnosis of CML. The patient did not response to STI571 600 mg/d for two months and received HLA haploidentical brother bone marrow transplantation (BMT) without ex-vivo T cell depletion and acquired complete remission (CR). 100 days after transplantation, the patient relapsed in the form of AML-M2. Case 2, female, 54 yrs, five months after diagnosis of CML, she received HLA-identical brother HSCT and acquired CR. Four months after transplantation, karyotyping showed 46, XX, t(9;22)(q34;q11)[7]/46, idem, +mar1, +mar2,+mar3[3], FISH showed 500/1000 donor cells, which suggested disease progression. 31 days (case 1) and 26 days (case 2) respectively after treatment with STI571 and DLI, they acquired CR which was confirmed by morphology, normal karyotype by conventional cytogenetics and X/Y, BCR/ABL FISH, and negative BCR/ABL by FISH and RT-PCR. As of July 2005, the two patients were in continuous complete remission for 25 (case 1) and 24 (case 2) months. We conclude that Imatinib mesylate with DLI is very effective in the treatment CML after relapse following allo-HSCT, and deserve further investigation for its effectiveness and mechanism.

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