Successful graft-versus-leukemia effect of second bone marrow transplantation on relapsed leukemia cutis that was refractory to intensive chemotherapy and donor lymphocyte transfusions in a patient with acute monocytic leukemia

We report a patient with acute monocytic leukemia (AMoL; M5) who received a second bone marrow transplantation (BMT) with graft-versus-leukemia (GVL) effect on relapsed leukemia cutis, which had been refractory to intensive c hemotherapy and donor lymphocyte transfusions (DLTs). A 21-year-old woman w as diagnosed with AMoL and achieved complete remission after intensive chem otherapy. The patient received a nonmanipulated allogeneic BMT from her HLA -identical father. Skin tumors developed in her upper extremities, chest, a nd thigh 11 months after BMT. Leukemia cutis was confirmed by skin biopsy. There was no evidence of relapse in bone marrow. The patient received sever al courses of chemotherapy and DLTs for the skin relapse, but the skin tumo rs persisted. The patient then received a second BMT from the same donor. O n day 80, grade II acute graft-versus-host disease developed, and the remai ning skin tumors were eradicated on day 98, most probably because of GVL ef fect. Int J Hematol. 2000;71:385-388. (C) 2000 The Japanese Society of Hema tology.