Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

Localized Relapse in Bone Marrow in a Posttransplantation Patient with t(6;9) Acute Myeloid Leukemia

  • 56 Accesses

  • 9 Citations


We report a 38-year-old woman with t(6;9) acute myeloid leukemia who relapsed with localized leukemic cell growth in the bone marrow after she had undergone allogeneic bone marrow transplantation. The localized cell growth was first recognized by an apparent discrepancy in the DEK-CAN fusion transcript levels between the aspirates from the left and right iliac bone marrow. Magnetic resonance imaging of the iliac bone revealed localized cell accumulation in the left side. The nonhomogeneous and localized leukemic cell growth in this case may have been due to the graft-versus-leukemia effect following allogeneic transplantation with donor lymphocyte infusion. Serial monitoring of molecular markers for leukemia at different sites or magnetic resonance imaging of the bone marrow may be of value in detecting this type of relapse.

This is a preview of subscription content, log in to check access.


  1. 1.

    Greer JP, Baer MR, Kinney MC. Acute myelogeneous leukemia. In: Lee GR, Bithell TC, Foerster J, Athens JW, Lukens JN, eds.Wintrobe’s Clinical Hematology. Malvern, Pa:Williams &Wilkins; 1999: 2272–2319.

  2. 2.

    Marcucci G, Livak K, Bi W, Strout MP, Bloomfield CD, Caligiuri MA. Detection of minimal residual disease in patients with AML1/ ETO-associated acute myeloid leukemia using a novel quantitative reverse transcription polymerase chain reaction assay.Leukemia. 1998;12:1482–1489.

  3. 3.

    von LindernM, Fornerod M, van Saal S, et al. The translocation (6;9), associated with a specific subtype of acute myeloid leukemia, results in the fusion of two genes, dek and can, and the expression of a chimeric, leukemia-specific dek-can mRNA.Mol Cell Biol. 1992;12:1687–1697.

  4. 4.

    Okamoto T, Kanamaru A, Shimazaki C, et al. Combination chemotherapy with risk factor-adjusted dose attenuation for high-risk myelodysplastic syndrome and resulting leukemia in the multicenter study of the Japan Adult Leukemia Study Group (JALSG): results of an interim analysis.Int J Hematol. 2000;72:200–205.

  5. 5.

    Martens ACM, Schultz FW, Hagenbeek A. Nonhomogeneous distribution of leukemia in the bone marrow during minimal residual disease.Blood. 1987;70:1073–1078.

  6. 6.

    Takagi S, Tanaka O, Yasusada M. Magnetic resonance imaging of femoral marrow in patients with myelodysplastic syndromes or leukemia.Blood. 1995;86:316–322.

  7. 7.

    Takagi S, Tanaka O. Magnetic resonance imaging of femoral marrow predicts outcome in adult patients with acute myeloid leukaemia in complete remission.Br J Haematol. 2002;117:70–75.

  8. 8.

    Slavin S, Morecki S, Weiss M, Or R. Donor lymphocyte infusion: the use of alloreactive and tumor-reactive lymphocytes for immunotherapy of malignant and nonmalignant diseases in conjunction with allogeneic stem cell transplantation.J Hematother Stem Cell Res. 2002;11:265–276.

  9. 9.

    Soekarman D, von LindernM, Daenen S, et al. The translocation (6;9)(p23;q34) shows consistent rearrangement of two genes and defines a myeloproliferative disorder with specific clinical features.Blood. 1992;79:2990–2997.

  10. 10.

    Lillington DM, MacCallum PK, Lister TA, Gibbons B. Translocation t(6;9)(p23;q34) in acute myeloid leukemia without myelodys-plasia or basophilia: two cases and a review of the literature.Leukemia. 1993;7:527–531.

  11. 11.

    Nakano H, Shimamoto Y, Suga K, Kobayashi K. Detection of minimal residual disease in a patient with acute myeloid leukemia and t(6;9) at the time of peripheral blood stem cell transplantation.Acta Haematol. 1995;94:139–141.

  12. 12.

    Boer J, Mahmoud H, Raimondi S, Grosveld G, Krance R. Loss of the DEK-CAN fusion transcript in a child with t(6;9) acute myeloid leukemia following chemotherapy and allogeneic bone marrow transplantation.Leukemia. 1997;11:299–300.

  13. 13.

    Yin JA, Tobal K. Detection of minimal residual disease in acute myeloid leukaemia: methodologies, clinical and biological significance.Br J Haematol. 1999;106:578–590.

Download references

Author information

Correspondence to Tetsuo Maeda or Satoru Kosugi or Hidetoshi Ujiie or Kazuoki Osumi or Takashi Fukui or Hitoshi Yoshida or Hirokazu Kashiwagi or Jun Ishikawa or Yoshiaki Tomiyama or Yuji Matsuzawa.

About this article

Cite this article

Maeda, T., Kosugi, S., Ujiie, H. et al. Localized Relapse in Bone Marrow in a Posttransplantation Patient with t(6;9) Acute Myeloid Leukemia. Int J Hematol 77, 522–525 (2003). https://doi.org/10.1007/BF02986623

Download citation

Key words

  • Real-time PCR
  • Minimal residual disease
  • MRD
  • Acute myeloid leukemia
  • AML
  • Bone marrow transplantation