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Clonal expansion after bone marrow transplantation in a patient with chronic myelogenous leukemia

✍ Scribed by Macera, M. J. ;Botti, A. C. ;Verma, R. S. ;Coleman, M. ;Thomas, E. Donnall

Publisher
Springer-Verlag
Year
1988
Weight
345 KB
Volume
57
Category
Article
ISSN
1432-0584

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✦ Synopsis

A patient with chronic myelogenous leukemia (CML) having the standard [t(9;22), Ph] translocation is presented where the Philadelphia (Ph) chromosome disappeared following bone marrow transplantation (BMT). The Ph chromosome reappeared in host cells after one year of stable hematologic remission. Three additional cell lines, all possessing the Ph chromosome with other abnormalities were consistently present in her marrow cells. Two years after BMT, ninety percent of her dividing bone marrow cells had become leukemic. The patient's clinical status remains unchanged, despite complex cytogenetic findings. The high incidence of multiple aberrant leukemic clones present in this case remains intriguing. Possible mechanisms for this unique transformation after BMT are discussed.

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