DONOR LEUKOCYTE TRANSFUSIONS AND DISCONTINUATION OF IMMUNOSUPPRESSANTS TO ACHIEVE AN INITIAL REMISSION AFTER ALLOGENEIC BONE-MARROW TRANSPLANTATION IN A PATIENT WITH PRIMARY REFRACTORY ACUTE-LEUKEMIA

We present a female patient who received an allogeneic bone marrow tra nsplantation for primary refractory Philadelphia-positive acute biphen otypic leukemia, Since leukemic blasts were persistently present in pe ripheral blood and bone marrow, in spite of the evidence for engraftme nt of male donor hematopoiesis, we performed donor leukocyte transfusi ons and discontinued immunosuppression, An initial complete remission was obtained 15 weeks after allogeneic bone marrow transplantation, an d lasted for 24 weeks, We concluded that the prominent mechanism for t he eradication of the refractory leukemic clone in the patient was the graft-versus-leukemia effect.