Unrelated Bone Marrow Transplantation for Super High Risk Acute Leukemia in First Remission.
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We performed successfully unrelated bone marrow transplantation (BMT) for a 14-year-old boy with super high risk acute leukemia. Peripheral leukocyte counts were 134, 500/μl with 93.0% blasts on admission. Monoclonal antibody study showed that the blasts expressed mixed lineage phenotypes. Chromosomal analysis revealed that karyotype of the blasts was 46, XY, 9p?, 13p+, 19p+. Because of lack of related donors and poor response to initial steroid treatment, he received unrelated BMT during first remission. On donor selection, in addition to serological HLA typing and mixed lymphocyte cultures, HLA-DR and-DQ genes were matched. by DNA restriction fragment length polymorphism typing, and HLA-DPB1 gene by using oligonucleotide probes. Despite the intensive prophylaxis for infection, multiple micro abscesses developed in liver and spleen on 25 days after BMT, which reduced by the intravenous administration of fluconazol. He has also suffered from chronic graft-versus-host disease since approximately 40 days after BMT, which was improved with prednisolone. Less than 30% of potential recipients have HLA-identical siblings who can act as donors. When a suitable donor is carefully selected by mixed lymphocyte cultures and HLA-DNA typing, unrelated BMT may be performed more safely for patients lacking related donors.
- 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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