INTERFERON-ALPHA TREATMENT OF ACUTE LYMPHOBLASTIC-LEUKEMIA RELAPSE AFTER UNRELATED BONE-MARROW TRANSPLANTATION

A 32-year-old Japanese male in his second remission of acute lymphobla stic leukemia (ALL) received a matched unrelated donor bone marrow tra nsplant (BMT) from the Japan Marrow Donor Program. On day + 83, a bone marrow examination revealed 5.2% leukemic cells. Despite the cessatio n of cyclosporine, leukemic cells in the bone marrow increased to 18.4 % on day +91. Treatment was started with interferon (IFN)-alpha-2b 3 x 10(6) U/body s.c. daily on day + 92 and leukemic cells in the bone ma rrow disappeared completely. The toxicity of IFN-a treatment included leukoencephalopathy consisting of somnolence, disorientation, short-te rm memory loss, lack of coordination and ataxia, myelotoxicity requiri ng multiple platelet transfusions and exacerbation of graft-versus-hos t disease (GVHD) of oral cavity, skin and lung. Because of progressive GVHD, IFN-alpha was discontinued on day + 124. On day + 132, a bone m arrow aspirate showed 6.4% leukemic cells. The patient died of progres sive ALL on day + 178. IFN-alpha may be useful for the treatment of le ukemic relapse following BMT, although its toxicity is marked. (C) 199 8 Elsevier Science Ireland Ltd. All rights reserved.