Loss of mismatched HLA in myeloid/NK cell precursor acute leukemia relapse after T cell-replete haploidentical hematopoietic stem cell transplantation

Pediatr Blood Cancer. 2014 Oct;61(10):1880-2. doi: 10.1002/pbc.24962. Epub 2014 Jan 25.

Abstract

Myeloid/natural killer cell precursor acute leukemia (MNKL) is an aggressive disease with a high relapse rate even after allogeneic hematopoietic stem cell transplantation (SCT). We report a patient with MNKL who had a donor lymphocyte infusion (DLI) for relapse after T cell-replete human leukocyte antigen (HLA)-haploidentical SCT, but relapsed again 20 months later with loss of mismatched HLA. This case suggests that a strong graft-versus-leukemia effect of haploidentical SCT can be expected in MNKL patients. In the haploidentical setting, DLI should be considered for patients with relapsed leukemia whose leukemic cells have not lost HLA cell surface expression.

Keywords: BMT; acute; graft versus host disease; hematology/oncology; leukemias; rare tumors; stem cell transplantation.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Graft vs Host Disease / immunology
  • HLA Antigens / immunology*
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Killer Cells, Natural / pathology
  • Leukemia, Myeloid, Acute / immunology*
  • Leukemia, Myeloid, Acute / surgery
  • Male
  • Neoplasm Recurrence, Local / immunology*

Substances

  • HLA Antigens