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Reduced-intensity bone marrow transplantation from an alternative unrelated donor for myelodysplastic syndrome of first-donor origin. 2003
Yukiko Komeno, and
Yoshinobu Kanda, and
Koji Kandabashi, and
Masahito Kawazu, and
Susumu Goyama, and
Masataka Takeshita, and
Yasuhito Nannya, and
Miyuki Niino, and
Tetsuya Nakamoto, and
Mineo Kurokawa, and
Shiho Tsujino, and
Seishi Ogawa, and
Katsunori Aoki, and
Shigeru Chiba, and
Toru Motokura, and
Hisamaru Hirai
Department of Cell Therapy & Transplantation Medicine, University of Tokyo Hospital, Japan.
A male patient had a relapse of myelodysplastic syndrome (MDS) 2 years after BMT from a female matched unrelated donor. Conventional cytogenetics, FISH, and short-tandem repeat chimerism analysis proved a relapse of donor origin. He underwent reduced-intensity BMT after a conditioning with fludarabine and busulfan, since he had impaired renal, liver, and pulmonary functions. Chimerism analysis on day 28 after the second BMT showed mixed chimerism of the first and the second donors, which later turned to full second-donor chimerism on day 60. He developed grade II acute GVHD of the skin and cytomegalovirus reactivation, but both were improved with methylprednisolone and ganciclovir, respectively. He remains in complete remission 6 months after the second BMT. Reduced-intensity second BMT from an alternative donor appeared to be a tolerable treatment option for donor-derived leukemia/MDS after the first conventional transplantation.
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