Molecular monitoring of minimal residual disease in two patients with MLL-rearranged acute myeloid leukemia and haploidentical transplantation after relapse

This report describes the clinical courses of two acute myeloid leukemia patients. Both had MLL translocations, the first a t(10;11)(p11.2;q23) with MLL-AF10 and the second a t(11;19)(q23;p13.1) with MLL-ELL fusion. They
This report describes the clinical courses of two acute myeloid leukemia patients. Both had MLL translocations, the first a t(10;11)(p11.2;q23) with MLL-AF10 and the second a t(11;19)(q23;p13.1) with MLL-ELL fusion. They achieved a clinical remission under conventional chemotherapy but relapsed shortly after end of therapy. Both had a history of invasive mycoses (one had possible pulmonary mycosis, one systemic candidiasis). Because no HLA-identical donor was available, a haploidentical transplantation was performed in both cases. Using a specially designed PCR method for the assessment of minimal residual disease (MRD), based on the quantitative detection of the individual chromosomal breakpoint in the MLL gene, all patients achieved complete and persistent molecular remission after transplantation. The immune reconstitution after transplantation is described in terms of total CD3+/CD4+, CD3+/CD8+, CD19+, and CD16+/CD56+ cell numbers over time. The KIR and HLA genotypes of donors and recipients are reported and the possibility of a KIR-mediated alloreactivity is discussed. This report illustrates that haploidentical transplantation may offer a chance of cure without chronic graft-versus-host disease in situations where no suitable HLA-identical donor is available even in a high-risk setting and shows the value of MRD monitoring in the pre- and posttransplant setting.
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Author:Thomas Burmeister, Mara Molkentin, Claus Meyer, Nils Lachmann, Stefan Schwartz, Birte Friedrichs, Jörg Beyer, Igor Wolfgang Blau, Gunnar Lohm, Carola Tietze-Bürger, Rolf Marschalek, Lutz Uharek
URN:urn:nbn:de:hebis:30:3-237427
DOI:http://dx.doi.org/doi:10.1186/2162-3619-1-6
ISSN:2162-3619
Parent Title (English):Experimental hematology & oncology
Publisher:BioMed Central
Place of publication:London
Document Type:Article
Language:English
Date of Publication (online):2012/04/25
Date of first Publication:2012/04/18
Publishing Institution:Univ.-Bibliothek Frankfurt am Main
Release Date:2012/04/25
Tag:Acute myeloid leukemia; Haploidentical stem cell transplantation; KIR; MLL; Minimal residual disease
Volume:1
Issue:6
Pagenumber:10
HeBIS PPN:307227634
Institutes:Medizin
Dewey Decimal Classification:610 Medizin und Gesundheit
Sammlungen:Universitätspublikationen
Licence (German):License LogoCreative Commons - Namensnennung 3.0

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