A Case of Acute Lymphocytic Leukemia Successfully Treated with Allogeneic Bone Marrow Transplantation

Abstract

A 27-year old male patient with acute lymphocytic leukemia who had shown resistance to repeated chemotherapies, was successfully grafted with bone marrow from his HLA-matched sister. Prior to bone marrow transplantation (BMT), he received the combined chemotherapy (DCMP) and was conditioned with cyclophosphamide 60 mg/kg/day on two successive days, followed by 1000 rads total body irradiation (TBI). Marrow cells (1.5×10¹⁰) were infused intravenously 24 hours after TBI. Successful engraftment has been demonstrated karyotypically (sex marker) by replacement of bone marrow and peripheral blood cells with those of donor. He received intermittent amethopterin after BMT to prevent graft-versus-host disease (GVHD). Three weeks after BMT, however, developed moderate GVHD of grade I-II in the skin and liver, which was fortunately well controled with predonisolone. In addition interstitial pneumonia developed 140 days after BMT and again was well controled with high dose of prednisolone. Now 700 days after BMT, he has been well in complete remission.
This case is the longest survivor among those who were treated with allogeneic BMT for hematological malignancy in Japan.