In January 1982, a 16 year-old male suffered from epigastralgia and melena. A submucosal tumor was endoscopically found in his stomach. Then, the biopsy examination revealed that it was pathologically a Burkitt's lymphoma. The involvement of bone marrow was also clarified by bone marrow aspiration. Soon after admission to our hospital, he was treated with vincristine and prednisolone. With this therapy, a complete remission was easily attained and thereafter, a subtotal gastrectomy and splenectomy were performed for a consolidative purpose. The pathological examination of resected stomach and lymphnodes demonstrated the existence of residual tumor cells.
On 12 March 1982, he was transplanted with bone marrow from his HLA-compatible brother; the number of infused cells was 2.5×108/kg. Intravenous injections of high dose of cyclophosphamide (3 g/day for two successive days) and fractionated total body irradiation (240 rad×4 times) were employed for preconditioning of this transplantation. His hematopoietic recovery was rapid after transplantation; that is, his peripheral leukocytes increased beyond 1,000/μl on the 21st transplantation day. However, a graft-versus-host disease (GVHD) was suspected from the observation that fever, skin rash and liver dysfunction appeared since the 16th transplantation day. Accordingly, he was treated with a combination of prednisolone (30 mg/d) and Bredinin (100 mg/d). After the treatment, all the symptoms disappeared soon. The titer of anti-cytomegalovirus antibody in his serum elevated gradually since the 21st transplantation day, with the maximum titer of ×512 (CF assay) on the 60th transplantation day. At present (September 1985), he is in healthy condition without any sign of GVHD.
