A Case of CML in Remission for 2 Years, Treated with IFN-.ALPHA. and Subsequent Allogeneic BMT with Little BU/CY Regimen.
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A 13-year-old boy diagnosed as having Philadelphia chromosome-positive chronic myelogeneous leukemia received interferon-alpha therapy and a cytogenetical minor response was obtained. Subsequently, bone marrow from his HLA-identical MLC-negative sister was transplanted. As a conditioning regimen, little BU/CY was applied instead of a total body irradiation-containing regimen. The doses of each drug were calculated on the basis of ideal body weight. Significant regimen-related toxicity was not observed. Monitoring of minimal residual disease by RT-PCR and endocrinological evaluation were performed for 2 years following BMT and no chimera mRNA from BCR-ABL fusion gene were detected. GH secretion stimulated by L-dopa and arginine showed normal response and the boy's height increased at a normal rate. However, LH-RH test showed hypersecretion of LH and FSH whereas serum testosterone and IGF-1 levels were appropriate for his age. Thus, normal development of pubertal process was observed during the next 2 years. These data indicated the presence of mild hypergonadtropic hypogonadism. In addition, TRH test showed hypersecretion of TSH and prolactin, although serum T3, T4 and TSH were all within the normal range, which suggested latent hypothyroidism. This case suggested that : 1) preconditioning by little BU/CY is safe and effective, when cyotogenetical minor response is obtained by IFN-alpha, 2) endocrine organ dysfunction may be caused by this conditioning regimen.
- 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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