Treatment of acute promyelocytic leukaemia relapsing after allogeneic bone marrow transplantation with all-trans-retinoic acid: suppression of the leukaemic clone
| Autor: | John Bashford, James S. Wiley, Martin B. Van Der Weyden, Michael F. Buckley, O. Margaret Garson, Jeff Szer |
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| Rok vydání: | 1991 |
| Předmět: |
Adult
Male medicine.medical_specialty Myeloid Clone (cell biology) Tretinoin Leukemia Promyelocytic Acute Internal medicine medicine Humans Bone pain Bone Marrow Transplantation Hematology business.industry Remission Induction medicine.disease Pancytopenia Clone Cells Leukemia medicine.anatomical_structure Immunology Bone marrow medicine.symptom business medicine.drug |
| Zdroj: | British Journal of Haematology. 79:331-334 |
| ISSN: | 1365-2141 0007-1048 |
| DOI: | 10.1111/j.1365-2141.1991.tb04542.x |
| Popis: | Summary We describe the clinical experience of a male patient with acute promyelocytic leukaemia, relapsing after sex-mismatched allogeneic bone marrow transplantation and treated with all-trans-retinoic acid. Resolution of the coagulopathy was observed by day 7 of therapy. A complete remission was achieved by day 47 after a period of pancytopenia, dysplastic myeloid maturation and bone marrow hypo-cellularity with necrosis and fibrosis. Serial cytogenetic analyses revealed a progressive loss of the male leukaemic clone [46XY, t(15;17)] and emergence of normal female (donor) cells [46XX] which became completely dominant with remission. Adverse effects of all-trans-retinoic acid included bone pain and a prominent leucocytosis requiring leukaphereses and hydroxyurea therapy. All-trans-retinoic acid can induce complete remission of recurrent acute promyelocytic leukaemia following bone marrow transplantation. The data suggest that remission is due to differentiation and suppression of the leukaemic clone while allowing repopulation of the marrow with non-malignant cells. |
| Databáze: | OpenAIRE |
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