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Successful treatment of hematological and extramedullary relapse of MLL-positive acute lymphoblastic leukemia after bone marrow transplantation using donor leukocyte infusion

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Abstract

Low response rates (range: 0–33%) were reported in acute lymphoblastic leukemia (ALL) patients who relapsed after bone marrow transplantation (BMT) and received donor leukocyte infusions (DLI). We describe an ALL patient who presented with a relapse in blood, bone marrow, breast, and axillary nodes 3 months after BMT from an unrelated donor. She achieved a second hematological complete remission (CR) after chemotherapy, with persistence of MLL-AF4 transcript in the bone marrow. DLI induced a long-lasting molecular CR that persisted on day 630 of DLI and was associated with a grade III graft-versus-host disease, which was controlled by prednisone, cyclosporine, and infliximab. This case report suggests the existence of an important graft-versus-leukemia (GVL) effect in patients with ALL and adds evidence for the activity of DLI towards extrahematological recurrences and ALL patients carrying t(4;11).

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Authors and Affiliations

  1. Chair and Division of Hematology, Bone Marrow Transplantation Unit, Department of Clinical and Morphological Research, University Hospital, Udine, 33100, Italy

    Francesca Patriarca, Alessandra Sperotto, Cristina Skert, Daniela Damiani, Simonetta Prosdocimo & Renato Fanin

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  1. Francesca Patriarca
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  2. Alessandra Sperotto
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  3. Cristina Skert
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  4. Daniela Damiani
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  5. Simonetta Prosdocimo
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  6. Renato Fanin
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Correspondence to Francesca Patriarca.

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Patriarca, F., Sperotto, A., Skert, C. et al. Successful treatment of hematological and extramedullary relapse of MLL-positive acute lymphoblastic leukemia after bone marrow transplantation using donor leukocyte infusion. Ann Hematol 83, 667–669 (2004). https://doi.org/10.1007/s00277-004-0880-9

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  • DOI: https://doi.org/10.1007/s00277-004-0880-9

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