Late relapse of acute myelogenous leukemia followed by Epstein-Barr virus-associated lymphoproliferative disease 11 years after allogeneic bone marrow transplantation

Yoshikane Kikushige, Ken Takase, Toshihiro Miyamoto, Akihiko Numata, Kenjiro Kamesaki, Takahiro Fukuda, Koji Nagafuji, Hisashi Gondo, Mine Harada

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Abstract

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) following myeloablative conditioning represents the treatment of choice for patients with chemotherapy-resistant leukemia. We describe a 49-year-old man with advanced, refractory acute myelogenous leukemia (AML) that was treated successfully by allogeneic bone marrow transplantation from a sibling donor with HLA mismatched at 1 locus. However, the patient developed a quiescent form of chronic graft-versus-host disease (GVHD) 7 years after transplantation, requiring long-term immunosuppressive therapy. AML relapse was documented 11 years after transplantation. Subsequently, Epstein-Barr virus (EBV)-associated posttransplantation lymphoproliferative disorder (PTLD) was also diagnosed. Immune reconstitution after allo-HSCT might have been impaired by the persistent chronic GVHD and the prolonged administration of immunosuppressive agents. As a result, immune surveillance against remaining quiescent leukemic cells as well as viral infection may have been defective, leading to the relapse of leukemia and EBV-associated PTLD.

Original languageEnglish
Pages (from-to)441-444
Number of pages4
JournalInternational journal of hematology
Volume84
Issue number5
DOIs
Publication statusPublished - Dec 1 2006

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All Science Journal Classification (ASJC) codes

  • Hematology

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