Successful Allogeneic Bone Marrow Transplantation for a Case of Acute Megakaryoblastic Leukemia Refractory to Induction Therapy

Abstract

We reported a case of acute megakaryoblastic leukemia refractory to induction chemotherapy, who finally achieved a complete remission with allogeneic bone marrow transplantation. The patient was a seven-month-old boy who had been treated with 4 courses of intensive chemotherapy including daunorubicin, cytosine arabinoside, etoposide, 6-mercaptopurine and mitoxantrone without complete remission. Six months after the diagnosis, he underwent allogeneic bone marrow transplantation from HLA phenotypically identical, mixed lymphocyte culture reaction negative father. Conditioning regimen consisted of busulfan 120 mg/m²/day for 4 days and cyclophosphamide 60 mg/kg/day for 2 days. He has remained in complete remission for 27 months following transplant. For patients with acute leukemia refractory to induction chemotherapy, high dose chemotherapy followed by allogeneic bone marrow transplantation may be effective, if it is performed before the appearance of a resistance to anti-cancer drugs or severe complications due to repeated intensive chemotherapy.