Chronic myeloid leukemia relapsing ten years after allogenic bone marrow transplantation

HINO Yutaro, DOKI Noriko, YAMAMOTO Keita, SENOO Yasushi, SASAJIMA Satoshi, SAKAGUCHI Masahiro, HATTORI Keiichiro, KAITO Satoshi, KUROSAWA Shuhei, HARADA Kaito, IKEGAWA Shuntaro, WATANABE Daisuke, HAGINO Takeshi, YOSHIOKA Kosuke, WATAKABE Kyoko, IGARASHI Aiko, NAJIMA Yuho, KOBAYASHI Takeshi, KAKIHANA Kazuhiko, SAKAMAKI Hisashi, OHASHI Kazuteru

doi:10.11406/rinketsu.57.608

A 58-year-old female was diagnosed with Philadelphia chromosome positive chronic myeloid leukemia (CML) in blast crisis (BC) in 2004. The patient received imatinib, which quickly induced molecular remission, and subsequently underwent bone marrow transplantation (BMT) from an unrelated human leukocyte antigen (HLA)-identical donor. The post-transplant clinical course was essentially uneventful. In 2014, ten years after the BMT, the patient was admitted to our hospital complaining of lymphadenopathy, and blasts were observed in peripheral blood. The patient was diagnosed as having a CML relapse in myeloid BC, with leukemic infiltration in lymph nodes, and was treated with dasatinib. Subsequently, pleural effusion developed and nilotinib was administered, which induced normal blood counts without blasts and partial cytogenetic remission, one month after administration. Six months after the relapse, this patient underwent a second BMT from an HLA-matched unrelated donor. Recent studies have demonstrated the cumulative incidence of CML relapse more than five years after allogeneic hematopoietic stem cell transplantation (allo-HSCT) to be higher than in acute myeloid leukemia. Although rare, the possibility of late relapse should be considered in patients diagnosed with CML after allo-HSCT.

Chronic myeloid leukemia relapsing ten years after allogenic bone marrow transplantation

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Chronic myeloid leukemia relapsing ten years after allogenic bone marrow transplantation

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