Cytogenetic evidence for recurrence of acute myelogenous leukemia after allogeneic bone marrow transplantation in donor hematopoietic cells

TitleCytogenetic evidence for recurrence of acute myelogenous leukemia after allogeneic bone marrow transplantation in donor hematopoietic cells
Publication TypeJournal Article
Year of Publication1978
AuthorsElfenbein GJ, Brogaonkar DS, Bias WB, Burns WH, Saral R, Sensenbrenner LL, Tutschka PJ, Zaczek BS, Zander AR, Epstein RB, Rowley JD, Santos GW
JournalBlood
Volume52
Issue3
Pagination627 - 36
Date PublishedSep
Accession Number354703
Keywords*Bone Marrow Transplantation, Adult, Hematopoietic Stem Cells, Humans, Leukemia, Myelocytic, Acute / genetics / pathology, Male, Microscopy, Fluorescence, Recurrence, Research Support, U.S. Gov't, P.H.S., Sex Chromosomes, Transplantation, Homologous
Abstract

A 22-yr-old man with acute myelocytic leukemia received a bone marrow transplant from a genotypically HLA-identical female sibling after cyclophosphamide preparation. He remained in complete remission for 18 mo, when he developed a chloroma in the perineum. The chloroma was treated with local radiotherapy. The chloroma recurred 8 mo later and was treated with radiotherapy followed by combination chemotherapy. At 34 mo after transplant, marrow relapse and chloroma were documented. The first chloroma contained host cells by fluorescent Y-chromatin body analyses of interphase nuclei. All metaphase cells and karyotypes from peripheral blood and marrow samples showed no evidence of host cells from 3 wk after transplant through the time of marrow relapse. Data from autosomal and sex chromosome studies indicate that the marrow relapse occurred in cells of donor origin. A new consistent chromosome abnormality [45, X, -X, t(8;21) (q22; q22)] was observed in a majority of donor cells. The patient received a second bone marrow transplant from the same donor after preparation with busulfan and cyclophosphamide and attained a complete remission with full hematologic engraftment.

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