| Summary: | <p>Abstract</p> <p>This report describes the clinical courses of two acute myeloid leukemia patients. Both had <it>MLL</it> translocations, the first a t(10;11)(p11.2;q23) with <it>MLL-AF10</it> and the second a t(11;19)(q23;p13.1) with <it>MLL-ELL</it> fusion. They achieved a clinical remission under conventional chemotherapy but relapsed shortly after end of therapy. Both had a history of invasive mycoses (one had possible pulmonary mycosis, one systemic candidiasis). Because no HLA-identical donor was available, a haploidentical transplantation was performed in both cases. Using a specially designed PCR method for the assessment of minimal residual disease (MRD), based on the quantitative detection of the individual chromosomal breakpoint in the <it>MLL</it> gene, both patients achieved complete and persistent molecular remission after transplantation. The immune reconstitution after transplantation is described in terms of total CD3<sup>+</sup>/CD4<sup>+</sup>, CD3<sup>+</sup>/CD8<sup>+</sup>, CD19<sup>+</sup>, and CD16<sup>+</sup>/CD56<sup>+</sup> cell numbers over time. The KIR and HLA genotypes of donors and recipients are reported and the possibility of a KIR-mediated alloreactivity is discussed. This report illustrates that haploidentical transplantation may offer a chance of cure without chronic graft-versus-host disease in situations where no suitable HLA-identical donor is available even in a high-risk setting and shows the value of MRD monitoring in the pre- and posttransplant setting.</p>
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