Abstract
A 34-year-old female with acute lymphoid leukemia was admitted to hospital in May 2002. She received induction chemotherapy and achieved a complete remission (CR). She subsequently received one course of consolidation chemotherapy, after which she suffered a relapse. Re-induction chemotherapy was performed, and a second CR was achieved. As a cautionary measure, we searched for an HLA-matched donor but were unable to find one among her family or in the Bone Marrow Bank. In October 2002, while in complete remission, she underwent an unrelated umbilical blood transplant after undergoing total body irradiation (TBI) and was subsequently treated with cyclophosphamide (CY). For graft versus host disease (GVHD) prophylaxis, she was given tacrolimus and methotrexate. The infused umbilical blood provided 3.02×10 (7) nucleated cells per kg ; the HLA profile contained 3 mismatched loci (2 mismatches at the A locus and 1 mismatch at the B locus). Engraftment was obtained on post-transplant day 22, and no evidence of clinical acute GVHD was seen. The use of tacrolimus, administered by drip infusion on post-transplant days 1-42 and orally after day 42, was discontinued altogether on post-transplant day 100. She is currently in good condition eight months after undergoing the umbilical blood transplantation.
