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Persistent complete molecular remission after nilotinib and graft-versus-leukemia effect in an acute lymphoblastic leukemia patient with cytogenetic relapse after allogeneic stem cell transplantation

Author(s): Farnsworth Paul | Ward David | Reddy Vijay

Journal: Experimental Hematology & Oncology
ISSN 2162-3619

Volume: 1;
Issue: 1;
Start page: 29;
Date: 2012;
Original page

Keywords: Philadelphia chromosome positive acute lymphoblastic leukemia (PH + ALL) | Nilotinib | Extracorporeal photopheresis (ECP) | Graft-versus-host disease (GVHD) | Graft-versus-leukemia effect (GVL) | Hematopoietic stem cell transplantation (HSCT)

Abstract We report the successful treatment and sustained molecular remission using single agent nilotinib in a relapsed Philadelphia chromosome positive (Ph+) acute lymphoblastic leukemia patient after allogeneic hematopoietic stem cell transplantation. Compared to previously published studies, this is the first report where a patient did not receive additional chemotherapy after relapse, nor did she receive donor lymphocyte infusions. With nilotinib, the patient reverted back to normal blood counts and 100% donor reconstitution by single tandem repeat (STR) chimerism analysis in the bone marrow and in peripheral blood, granulocytes, T and B-lymphocytes. This report also highlights the use of nilotinib in combination with extracorporeal photopheresis (ECP) for concomitant graft-versus-host disease. Our data suggests that ECP, together with nilotinib, did not adversely affect the overall Graft-versus-leukemia (GVL) effect.
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