[Successful second transplant from one-locus HLA-mismatched unrelated donor for graft rejection following initial transplant from another unrelated donor in a patient with chronic myelogenous leukemia]

Rinsho Ketsueki. 2001 Aug;42(8):656-8.
[Article in Japanese]

Abstract

We report a patient with chronic myelogenous leukemia who received a second transplant from a one-locus HLA-mismatched unrelated donor after rejection of an initial bone marrow graft. For the first transplant, HLAs were fully matched, conditioning with busulfan + cyclophosphamide (CY) was applied, and cyclosporin A + short-term methotrexate (sMTX) was used for prophylaxis against GVHD. A complete chimera was not obtained, and the graft was rejected on day 122. For the second transplant, there was a one-HLA locus (DR) mismatch, conditioning was done with total body irradiation + cytarabine + CY, and GVHD prophylaxis consisted of FK506 + sMTX. Engraftment was obtained on day 27, and no graft failure was occurred at the time of writing. This case suggests that strong immunosuppression may have prevented rejection of the second bone marrow graft.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Bone Marrow Transplantation*
  • Graft Rejection / therapy*
  • Graft vs Host Disease / prevention & control
  • HLA Antigens*
  • Histocompatibility*
  • Humans
  • Immunosuppression Therapy
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / therapy*
  • Male
  • Reoperation
  • Tissue Donors*
  • Transplantation Conditioning
  • Treatment Outcome

Substances

  • HLA Antigens