1-3 LPD after allogeneic bone marrow transplant (BMT) runs a more aggressive course than that after organ transplantation. Cord blood (CB) is an alternative stem cell source containing early committed progenitor cells and immature lymphocytes. 4,5 Recent reports of transplants with related and/or unrelated partially HLA-mismatched CB have shown comparable engraftment with a small dose of nucleated cells (ෂ4 × 10 7 /kg), and a lower incidence of graft-versus-host disease (GVHD) than expected with BM grafts.5-7 CB transplant (CBT) may carry a low risk of EBV or cytomegalovirus (CMV)-associated complications because CB carries no herpes viruses. Despite the rapid increase in the number of CBT, post-transplant LPD has
Here we report a case with precursor natural killer (NK) cell leukemia successfully treated with an unrelated cord blood transplantation. A 7-month-old Japanese boy was diagnosed to have NK cell leukemia based on the existence of abnormal cells in the bone marrow with the phenotype of CD3(-) /CD4(+) /CD7(-) /CD8(-) /CD16(-) /CD33(+) /CD34(-) /CD56(+) /HLA-DR(+) /NKB1(+) / CD94(+). The leukemic cells showed few azurophilic granules in the cytoplasm and weak cytotoxic activity. Although he presented with a huge mass occupying the bilateral paranasal sinuses and hepatosplenomegaly, he achieved complete remission by the conventional chemotherapeutic regimen for acute myelogenous leukemia, followed by an unrelated cord blood transplantation. He has remained in complete remission for 14 months posttransplant. To our knowledge, this is the youngest reported case with precursor NK cell leukemia; cord blood transplantation may thus be the treatment of choice for this disease.
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