Recovery of normal autologous myelopoiesis after graft rejection following allogeneic bone marrow transplant for agnogenic myeloid metaplasia

S. Alkindi, J. H. Deeg, M. E D Flowers

Research output: Contribution to journalArticle

Abstract

Allogeneic hematopoietic transplantation is the only currently available therapy that has the potential to cure agnogenic myeloid metaplasia (AMM) or primary myelofibrosis (PMF). Amelioration of fibrosis and eradication of the abnormal clone is thought to occur through the repopulation of marrow by donor-derived hematopoiesis and graft-vs.-host reaction leading to graft vs. tumor effect. We report here a 50-year-old female with AMM/PMF, conditioned with busulfan and cyclophosphamide, who rejected a single locus (HLA-B) mismatched bone marrow transplant from her daughter, but recovered normal autologous hematopoiesis with disappearance of marrow fibrosis and extramedullary hematopoiesis. Variable number tandem repeats (VNTR) analysis showed a gradual loss of donor-derived hematopoietic cells with recovery of autologous hematopoiesis. This case therefore illustrates that eradication of AMM/PMF in this patient with myeloablative chemotherapy combined with a transient allogeneic effect was sufficient to suppress the abnormal stem cell clone associated with AMM/PMF with subsequent cure.

Original languageEnglish
Pages (from-to)134-137
Number of pages4
JournalClinical and Laboratory Haematology
Volume28
Issue number2
DOIs
Publication statusPublished - Apr 2006

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Keywords

  • Agnogenic myeloid metaplasia
  • Allogeneic bone marrow transplant
  • Autologous normal hematopoiesis
  • Graft failure
  • Primary myelofibrosis

ASJC Scopus subject areas

  • Hematology

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