乳児慢性骨髄単球性白血病における同種骨髄移植

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  • Allogeneic Bone Marrow Transplantation in an Infant with Chronic Myelomonocytic Leukemia.

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Allogeneic bone marrow transplantation (BMT) was performed in an infant with chronic myelomonocytic leukemia (CMMoL). The conditioning regimen included busulfan, cyclophosphamide, etoposide, and cytosine arabinoside. On day 53 post BMT, rejection of the graft and auto-hematopoiesis were confirmed by using the RFLP study of the HPRT gene on the X-chromosome. After BMT his spleen became bigger and severe anemia and thrombocytopenia were accelerated. Splenectomy was performed 13 months after BMT. Although the number of erythrocytes and platelets increased and he got well after splenctomy, he suddenly died 19 months after BMT, probably due to sepsis caused by deterioration of leukemia. It is possible that hypersplenism was a cause of graft failure. Splenectomy or irradiation to spleen followed by conditioning regimen employing TBI may be needed to reduce the incidence of graft failure in CMMoL.

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