| Popis: |
We report the case of a 32-year-old man with poor risk acute myeloid leukemia (AML) who received transplantation ofan UCB graft following myeloablative conditioning but unfortunately relapsed after one year with complete loss of donorchimerism. As this patient did not have an HLA - matched sibling donor or a volunteer MUD, he went on to receive a second transplant with haploidentical CD34 cells from his mother following a non-myeloablative conditioning. After initialengraftment with the haploidentical donor cells, the patient became progressively pancytopenic and chimerism analysisrevealed decreased level of cells derived from the haploidentical graft. However, there was a concurrent increasing ratio of the UCB derived cells from the first transplant. The patient had eventual recovery and stabilization of his full blood countand repeat chimerism analysis demonstrated successful re-engraftment with the previous UCB graft. To the best of ourknowledge, no such similar cases have been reported in the literature. Thus, cord blood cells from a prior transplant couldremain present in small quantities at the phase ofleukemia relapse and re-emerge to establish long term hematopoiesis evenafter graft failure from a subsequent haploidentical transplant. |
