Molecular monitoring of minimal residual disease in two patients with MLL-rearranged acute myeloid leukemia and haploidentical transplantation after relapse
Autor: | Nils Lachmann, Claus Meyer, Gunnar Lohm, Stefan Schwartz, Thomas Burmeister, Lutz Uharek, Mara Molkentin, Rolf Marschalek, Birte Friedrichs, Jörg Beyer, Carola Tietze-Bürger, Igor Wolfgang Blau |
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Rok vydání: | 2012 |
Předmět: |
MLL
Cancer Research medicine.medical_specialty Case Report Disease Human leukocyte antigen lcsh:RC254-282 hemic and lymphatic diseases Internal medicine Haploidentical stem cell transplantation medicine ddc:610 Acute myeloid leukemia Hematology lcsh:RC633-647.5 business.industry Minimal residual disease Myeloid leukemia lcsh:Diseases of the blood and blood-forming organs lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens medicine.disease KIR Transplantation Oncology Immunology Systemic candidiasis business CD8 |
Zdroj: | Experimental Hematology & Oncology, Vol 1, Iss 1, p 6 (2012) Experimental Hematology & Oncology |
ISSN: | 2162-3619 |
Popis: | This report describes the clinical courses of two acute myeloid leukemia patients. Both had MLL translocations, the first a t(10;11)(p11.2;q23) with MLL-AF10 and the second a t(11;19)(q23;p13.1) with MLL-ELL fusion. They achieved a clinical remission under conventional chemotherapy but relapsed shortly after end of therapy. Both had a history of invasive mycoses (one had possible pulmonary mycosis, one systemic candidiasis). Because no HLA-identical donor was available, a haploidentical transplantation was performed in both cases. Using a specially designed PCR method for the assessment of minimal residual disease (MRD), based on the quantitative detection of the individual chromosomal breakpoint in the MLL gene, both patients achieved complete and persistent molecular remission after transplantation. The immune reconstitution after transplantation is described in terms of total CD3+/CD4+, CD3+/CD8+, CD19+, and CD16+/CD56+ cell numbers over time. The KIR and HLA genotypes of donors and recipients are reported and the possibility of a KIR-mediated alloreactivity is discussed. This report illustrates that haploidentical transplantation may offer a chance of cure without chronic graft-versus-host disease in situations where no suitable HLA-identical donor is available even in a high-risk setting and shows the value of MRD monitoring in the pre- and posttransplant setting. |
Databáze: | OpenAIRE |
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