Allogeneic stem cell transplantation without preconditioning in a child with therapy-related myelodysplastic syndrome: A case report.

Content Provider	Europe PMC
Author	Tung, Yi-Ling Wang, Yi-Lun Chang, Tsung-Yen Chiu, Chia-Chi Wen, Yu-Chuan Jaing, Tang-Her
Copyright Year	2023
Abstract	Rationale:Infants with mixed-lineage leukemia (MLL)-rearranged leukemia are usually refractory to standard induction therapy and are not immediate candidates for allogeneic hematopoietic stem cell transplantation (allo-HSCT). Chromosome 11q23 translocations, resulting in MLL rearrangement, have been well characterized in infant acute lymphoblastic leukemia (ALL). While t(4;11) ALL continues to have carry a bleak prognosis, patients with therapy-related myelodysplastic syndrome (t-MDS) have a shorter median overall survival than those compared with de novo MDS.Patient concerns:We describe a child with t-MDS who evolved from MLL-rearranged ALL and was successfully treated with HSCT without toxic preconditioning.Diagnoses:MDS diagnosis was based on morphological characteristics of bone marrow dysplasia in patients with clinical manifestations evidence of hematopoiesis impairments by different combinations of anemia, leukopenia, neutropenia, and thrombocytopenia.Interventions:Although the best donor for allo-HSCT is generally considered an human leukocyte antigen-matched sibling, only ~ 30% of patients have a suitable sibling. HSCT from an unrelated donor is a suitable option for patients with t-MDS who do not have matched sibling donors.Outcomes:Allo-HSCT without recipient preconditioning could be a promising treatment option for t-MDS, especially for patients with recurrent or persistent infections.Lessons:Cytogenetics, prognosis, and treatment of t-MDS are briefly discussed. Preconditioning before allo-HSCT seriously damages immune function. This work reviews our experience with a patient with t-MDS following ALL complicated by recurrent infections, and highlights our choice to omit preconditioning from allo-HSCT.
ISSN	00257974
Journal	Medicine
Volume Number	102
PubMed Central reference number	PMC9907963
Issue Number	6
PubMed reference number	36820588
e-ISSN	15365964
DOI	10.1097/md.0000000000032770
Language	English
Publisher	Lippincott Williams & Wilkins
Publisher Date	2023-02-01
Publisher Place	Hagerstown, MD
Access Restriction	Open
Rights License	This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.
Subject Keyword	hematopoietic stem cell transplantation infant acute lymphoblastic leukemia recurrent infection therapy-related myelodysplastic syndrome
Content Type	Text
Resource Type	Article
Subject	Medicine