Abstract
We experienced a patient with Philadelphia chromosome-positive acute lymphoblastic leukemia. He was six years old at the first visit. Although chemotherapy for ALL was applied to him, early relapse and resistance to che-motherapy were noted. He received a stem cell transplantation from his 2-locus unmatched father. However, he showed testicular relapse one and a half years later. BFM protocol for relapsed ALL was used. He subsequently went into remission. But he developed femoral and tibial bone relapses after ten months of maintenance therapy. Following imatinib administration, local radiotherapy and donor-activated CD4 positive lymphocyte infusion, minor BCR-ABL disappeared. However, he showed various bone lesions thereafter and he was treated with local radiotherapy alone due to the myelosuppresion of imatinib. The whole clinical course was approximately 12 years. These results suggest that GVL effect plus imatinib have limited activity against extramedullary relapses.
