Relapse of host leukemic lymphoblasts following engraftment by an HLA-mismatched marrow transplant: mechanisms of escape from the "graft versus leukemia" effect. Exp Hematol 1985 Sep;13(8):782-90
Date
09/01/1985Pubmed ID
2931298Scopus ID
2-s2.0-0022214399 (requires institutional sign-in at Scopus site) 15 CitationsAbstract
Leukemic relapses and graft versus host disease (GvHD) remain major complications following allogeneic bone marrow transplantation for leukemia. We present clinical and laboratory details for an eight-year-old boy who received a T-cell-depleted HLA-mismatched marrow transplant as therapy for acute lymphoblastic leukemia (ALL) in second remission. Engraftment with donor marrow was prompt and without any acute GvHD. Nevertheless, the patient's original ALL recurred and proved fatal. The patient remained a chimera with persistent donor lymphocytes present at the time of posttransplant relapse and subsequent to treatment with unsuccessful reinduction chemotherapy. In vitro immune studies showed that these leukemic cells could be recognized and destroyed by the donor's lymphocytes. The relapse itself suggests, however, that the donor's lymphocytes did not effectively destroy the patient's histoincompatible ALL cells in vivo following establishment of the chimeric state. Potential mechanisms are presented to account for this presumed "escape" from the postulated "graft versus leukemia" effect.
Author List
Sondel PM, Hank JA, Molenda J, Blank J, Borcherding W, Longo W, Trigg ME, Hong R, Bozdech MJAuthor
Walter L. Longo MD Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Acute DiseaseBone Marrow
Bone Marrow Transplantation
Cell Division
Child
Chimera
Combined Modality Therapy
Cytotoxicity Tests, Immunologic
Graft vs Host Disease
HLA Antigens
Histocompatibility
Histocompatibility Testing
Humans
Infant, Newborn
Leukemia, Lymphoid
Lymphocyte Culture Test, Mixed
Male
Phenotype
