INFUSION OF TUMOR-CONTAMINATED BONE-MARROW FOR AUTOLOGOUS RESCUE AFTER HIGH-DOSE THERAPY LEADING TO LONG-TERM REMISSION IN A PATIENT WITH RELAPSED PHILADELPHIA-CHROMOSOME-POSITIVE ACUTE LYMPHOBLASTIC-LEUKEMIA

We report a female patient with relapse Philadelphia chromosome-positi ve acute lymphoblastic leukemia remaining in long-term second remissio n after high-dose radiochemotherapy followed by autologous stem cell r escue with bone marrow showing evidence of residual disease. The Phila delphia chromosome and a positive signal for the BCR/ABL p185 transloc ation by the polymerase chain reaction were detected in the harvested marrow. After mafosfamide-purged marrow failed to engraft, her unpurge d 'back-up' bone marrow was also infused. Control marrow examinations after recovery were repeatedly positive for the BCR/ABL translocation on PCR analysis turning negative 30 months after high-dose therapy. Sh e remains in unsustained complete clinical remission for 48+ months sh owing no evidence of leukemia by cytological and cytogenetic analyses.