Acute Lymphoblastic Leukemia of Male-Recipient Origin Demonstrating Female Karyotype After Cord Blood Transplantation

Abstract

A 12-year-old boy was diagnosed with French-American-British classification L2 acute lymphoblastic leukemia (ALL). He was treated according to the pediatric ALL protocol and achieved a complete remission (CR). When the patient was 22 years old, he presented with dyspnea. A CBC revealed a WBC of 1.2 ϫ 10 9 /L (blasts, 2%), a hemoglobin level of 5.8 g/dL, and a platelet count of 160 ϫ 10 9 /L. Bone marrow aspiration showed 88% blasts that were cytochemically negative to myeloperoxidase staining (Fig 1A). Flow cytometric immunophenotyping showed that the blasts were CD10Ϫ, CD19ϩ, CD13Ϫ, CD33ϩ, CD34ϩ, and HLA-DRϩ. Cytogenetic analysis showed a normal male karyotype, 46,XY, in each of the 20 metaphase cells analyzed (Fig 2A).

Chimerism status after unrelated donor bone marrow transplantation with fludarabine-melphalan conditioning is affected by the melphalan dose and is predictive of relapse

“…Granulocytes were collected by removing lysed red blood cells from the precipitate after incubation in ammonium chloride buffer. Following cell separation, DNA was extracted from the separated cells, and degrees of donor-recipient chimerism were analyzed with PCR of informative microsatellite regions [15,17,18]. Samples were prospectively analyzed on days 14, 28, 56, and 84.…”