Allogeneic CD34-Positive Marrow Cell Transplantation in Three Children with Refractory Leukemia.
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We report on three children with refractory leukemia who underwent transplants with CD34-positive bone marrow cells from HLA two-loci mismatched related donors. The first patient was a 4-year-old girl with acute myeloid leukemia with t (16 ; 21). She received the transplant during second complete remission. The second patient was a 7-year-old boy with B-cell acute lymphoblastic leukemia. He received the transplant during the refractory phase. The third patient was a 15-year-old boy with acute monocytic leukemia. He was transplanted in refractory phase. The conditioning regimen consisted of busulfan, melphalan and total body irradiation. The CD34-positive marrow cells were separated using an immunomagnetic cell-separation system (Isolex50®). The number of infused CD34-positive cells was 2.18×10<SUP>6</SUP>/kg, 2.80×10<SUP>6</SUP>/kg and 0.32×10<SUP>6</SUP>/kg, respectively. All three patients achieved engraftment without severe acute graft-versus-host disease (GVHD). The first patient is alive and well in hematological remission 26 months after transplantation. The second patient relapsed on day 68 after transplantation and died from multiple organ failure on day 97. The third patient died from cytomegalovirus pneumonia on day 54. CD34-positive marrow cell transplantation from HLA-mismatched related donors may be a useful method that provides hematopoietic engraftment without severe GVHD. But the increased risk of relapse and viral infection remain to be solved, and overcoming these problems is crucial to establish this method.
- 特定非営利活動法人 日本小児血液・がん学会の論文
特定非営利活動法人 日本小児血液・がん学会 | 論文
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