[Graft-versus-ATLL effect induced by abrupt discontinuation of immunosuppression following allogeneic bone marrow transplantation]

Gan To Kagaku Ryoho. 2005 Jun;32(6):867-71.
[Article in Japanese]

Abstract

A 46-year-old man was admitted to our hospital with swelling of a neck lymph node in June, 2002, and was diagnosed with adult T-cell leukemia/lymphoma (ATLL). As ATLL cells were detected in the peripheral blood after two courses of multi-agent chemotherapy (LSG 15), the treatment was changed to biweekly CHOP therapy. After two courses, hematological remission was achieved. Allogeneic bone marrow transplant (allo-BMT) from HTLV- negative and HLA-matched sibling donor was performed (conditioned with cyclophosphamide 60 mg/kg x 2 and total body irradiation 12 Gy). Cyclosporine A (CsA) and short-term methotrexate (MTX) were used for graft-versus-host disease prevention. Though the HTLV- provirus DNA (Southern blot) disappeared, HTLV-I provirus DNA (real-time PCR) T-cell receptor ygammachain gene rearrangement DNA (Southern blot) were detected in bone marrow after allo-BMT. MRD disappeared after the withdrawal of CsA. After the allo-BMT transplant, a graft-versus-ATLL (GVATLL) effect may be induced by abrupt discontinuation of immunosuppression.

Publication types

  • Case Reports

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Bone Marrow Transplantation*
  • Cyclophosphamide / administration & dosage
  • Cyclosporine / administration & dosage
  • DNA, Viral / analysis
  • Doxorubicin / administration & dosage
  • Graft vs Leukemia Effect*
  • Human T-lymphotropic virus 1 / genetics
  • Humans
  • Immunosuppression Therapy*
  • Leukemia-Lymphoma, Adult T-Cell / drug therapy
  • Leukemia-Lymphoma, Adult T-Cell / pathology*
  • Leukemia-Lymphoma, Adult T-Cell / therapy*
  • Male
  • Methotrexate / administration & dosage
  • Middle Aged
  • Neoplasm, Residual
  • Prednisone / administration & dosage
  • Remission Induction
  • Vincristine / administration & dosage

Substances

  • DNA, Viral
  • Vincristine
  • Doxorubicin
  • Cyclosporine
  • Cyclophosphamide
  • Prednisone
  • Methotrexate

Supplementary concepts

  • CHOP protocol