Inadvertent Transmission of a Donor's Acute Myeloid Leukemia in Bone Marrow Transplantation for Chronic Myelocytic Leukemia

Abstract

A PATIENT with Philadelphia chromosome-positive chronic myelocytic leukemia in a phase of accelerated growth received a bone marrow transplant from her HLA-identical brother, whose cells were not reactive in the mixed leukocyte culture. Although routine examination of the donor's peripheral blood before transplantation revealed no abnormalities, the bone marrow graft showed acute myeloid leukemia, with 38 percent leukemic blasts. The infusion of this leukemic bone marrow resulted in normal engraftment, with complete chimerism two months after transplantation. The specific cytogenetic abnormalities of both the donor and the host leukemias disappeared one month after transplantation and remained undetectable for four more… © 1990, Massachusetts Medical Society. All rights reserved.