PMID- 18306363
OWN - NLM
STAT- MEDLINE
DCOM- 20080708
LR  - 20080508
IS  - 1096-8652 (Electronic)
IS  - 0361-8609 (Linking)
VI  - 83
IP  - 6
DP  - 2008 Jun
TI  - Isolated extramedullary relapse presenting as autologous lymphocyte response.
PG  - 512-4
LID - 10.1002/ajh.21165 [doi]
AB  - Isolated EMR in the CNS is a relatively rare form of recurrent leukemia. We 
      report here a case of a 38-year-old man with inv(16) acute myeloid leukemia (AML, 
      M2) who suffered a central nervous system (CNS) relapse after allogeneic bone 
      marrow transplantation (BMT) from a human leukocyte antigen (HLA)-matched sibling 
      donor. After complete remission was achieved by chemotherapy, he received 
      allogeneic BMT from his HLA-matched sister. His leukemia relapsed in the CNS 2.5 
      years after the allogeneic BMT. Lumbar puncture revealed 780/muL white blood 
      cells with 67.3% leukemia cells and 32.7% mature lymphocytes. Fluorescent in situ 
      hybridization (FISH) using a probe for the Y chromosome demonstrated that both 
      leukemia cells and lymphocytes in the cerebrospinal fluid (CSF) were derived from 
      the recipient, although the bone marrow cells were from the donor. No leukemia 
      cells with inv(16) were detected by FISH in the bone marrow. This is the first 
      report to clarify the chimerism of lymphocytes in the CSF of patients with 
      isolated EMR in the CNS after allogeneic SCT, in which analysis revealed that 
      autologous immunologic cells rather than donor lymphocytes responded to the 
      recurrent isolated leukemic cells in CNS. This observation suggests that the CNS 
      is a "sanctuary" site not only from chemotherapy but also from the 
      graft-versus-leukemia effect. The present case contributes to our understanding 
      of the possibility of immunological escape phenomenon of recurrent leukemia cells 
      in extramedullary sites.
CI  - Copyright 2008 Wiley-Liss, Inc.
FAU - Imataki, Osamu
AU  - Imataki O
AD  - Division of Hematology, Department of Internal Medicine, Faculty of Medicine, 
      Kagawa University, Kagawa, Japan. oima@med.kagawa-u.ac.jp
FAU - Ohnishi, Hiroaki
AU  - Ohnishi H
FAU - Kitanaka, Akira
AU  - Kitanaka A
FAU - Kubota, Yoshitsugu
AU  - Kubota Y
FAU - Tanaka, Terukazu
AU  - Tanaka T
FAU - Ishida, Toshihiko
AU  - Ishida T
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Am J Hematol
JT  - American journal of hematology
JID - 7610369
SB  - IM
MH  - Adult
MH  - Bone Marrow Transplantation/methods
MH  - Central Nervous System Neoplasms/*pathology
MH  - Humans
MH  - Leukemia, Myeloid, Acute/*pathology/*therapy
MH  - Male
MH  - Recurrence
MH  - Sarcoma, Myeloid
MH  - Transplantation Chimera
EDAT- 2008/02/29 09:00
MHDA- 2008/07/09 09:00
CRDT- 2008/02/29 09:00
PHST- 2008/02/29 09:00 [pubmed]
PHST- 2008/07/09 09:00 [medline]
PHST- 2008/02/29 09:00 [entrez]
AID - 10.1002/ajh.21165 [doi]
PST - ppublish
SO  - Am J Hematol. 2008 Jun;83(6):512-4. doi: 10.1002/ajh.21165.