SUCCESSFUL SALVAGE USING MISMATCHED UMBILICAL-CORD BLOOD TRANSPLANT IN AN ADULT WITH RECURRENT ACUTE MYELOGENOUS LEUKEMIA FAILING AUTOLOGOUS PERIPHERAL-BLOOD PROGENITOR-CELL TRANSPLANT - A CASE-HISTORY AND REVIEW

We report a 26-year-old female with AML, FAB classification M5 who was initially treated with induction therapy consisting of idarubicin and cytarabine followed by high-dose cytarabine and autologous peripheral blood progenitor cell (PBPC) transplant for consolidation. The patien t remained in remission for 1 month post-PBPC transplant, when relapse was noted. Reinduction therapy with idarubicin, cytarabine and etopos ide was unsuccessful, and the patient underwent an unrelated, two-anti gen mismatched umbilical cord blood (UCB) transplant for salvage after melphalan plus total body irradiation. Complications post transplant included veno-occlusive disease, delayed engraftment, and acute grade III graft-versus-host disease (GVHD). The patient remains in remission 1 year post transplant. This study demonstrates the salvage capabilit y of UCB transplantation for refractory leukemia and its potential use in adult patients.