HLA HAPLOIDENTICAL CORD-BLOOD CELL TRANSPLANT IN A 15-YEAR-OLD, 50 KGWEIGHT PATIENT - SUCCESSFUL TREATMENT FOR CHRONIC MYELOID-LEUKEMIA AFTER MYELOID BLASTIC TRANSFORMATION

A 15-year-old, 50 kg weight patient with CML had a myeloblastic transf ormation which reverted to Ph negative remission with intensive chemot herapy 5 years after diagnosis. Umbilical cord blood (UCB) from an HLA -haploidentical sister had been frozen 2 years and 9 months before, as she had no HLA-identical sibling and no suitable unrelated donor had been found. UCB transplant was selected on the basis of previous gener al experience with this kind of transplant, lack of a better choice of donor, and likelihood of a prompt relapse of the disease without an a llo-transplant. Engraftment occurred without delay and the patient dev eloped grade II aGVHD as well as severe CsA toxicity which required di scontinuation of the drug, anti-IL2r being given instead. Subsequently she only had histologic evidence of cGVHD and 1.5 years after the tra nsplant she remains in complete hematologic remission with full chimer ism and without evidence of the bcr/abl fusion gene. This case illustr ates further possibilities of allotransplantation using UCB.