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Case Reports
Successful treatment of relapsed AML after allogeneic stem cell transplantation with azacitidine.
- Thorsten Graef, Andrea Kuendgen, Roland Fenk, Fabian Zohren, Rainer Haas, and Guido Kobbe.
- Department of Hematology, Oncology and Clinical Immunology, Heinrich-Heine University, Moorenstr. 5, 40225 Düsseldorf, Germany. graef@med.uni-duesseldorf.de
- Leuk. Res. 2007 Feb 1; 31 (2): 257-9.
AbstractTherapeutic options for patients with relapse of MDS or high risk AML after allogeneic stem cell transplantation are limited. We here present the case of a 64-year-old female patient with MDS, who received peripheral blood stem cells from her HLA-identical brother after a non-myeloablative conditioning regimen. Two months after allogeneic transplantation she suffered from a relapse, now fulfilling WHO criteria for AML with a bone marrow blast count of 91%. We then decided to treat her with azacitidine, a DNA methyltransferase inhibitor with proven antileukemic activity. The patient achieved a complete haematological response after two cycles and full donor chimerism after a single dose of donor lymphocytes. We postulate that azacitidine acts through a direct reduction of malignant cells and may in addition augment the immunologic effects of donor lymphocyte infusions.
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