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Allogeneic hematopoietic stem cell transplantation in a patient affected by large granular lymphocyte leukemia and multiple sclerosis

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Abstract

We describe a 57-year-old man, affected by large granular lymphocyte (LGL) leukemia and concomitant primary progressive multiple sclerosis (MS), treated with allogeneic hematopoietic stem cell transplantation (HSCT) from an HLA-identical sibling. The patient was conditioned with fludarabine, busulphan, and cyclophosphamide. Graft-versus-host disease (GVHD) prophylaxis consisted of cyclosporine and short-term methotrexate. At 3 years follow-up, the patient is in complete remission of LGL with a marked improvement in neurological conditions. This is the first case of allogeneic HSCT in a patient with LGL leukemia and concomitant primary progressive MS. Allogeneic HSCT, performed in our patient to cure the lymphoproliferative disorder, improved the clinical course of MS.

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References

  1. Greer JP, Kinney MC, Loughran TP Jr (2001) T cell and NK cell lymphoproliferative disorders. Hematology (Am Soc Hematol Educ Program) 259–281

  2. Noseworthy JH, Lucchinetti C, Rodriguez M, et al. (2000) Multiple Sclerosis. N Engl J Med 343:938–952

    Article  CAS  PubMed  Google Scholar 

  3. Compston DA, Coles A (2002) Multiple sclerosis. Lancet 359:1221–1231

    Article  PubMed  Google Scholar 

  4. Mancardi GL, Saccardi R, Filippi M, et al. (2001) Autologous hematopoietic stem cell transplantation suppresses Gd-enhanced MRI activity in MS. Neurology 57:62–68

    CAS  PubMed  Google Scholar 

  5. Fassas A, Passweg JR, Anagnostopoulos A, et al. (2002) Autoimmune Disease Working Party of the EBMT (European Group for Blood and Marrow Transplantation). Hematopoietic stem cell transplantation for multiple sclerosis. A retrospective multicenter study. J Neurol 249:1088–1097

    CAS  PubMed  Google Scholar 

  6. McAllister LD, Beatty PG, Rose J (1997) Allogeneic bone marrow transplant for chronic myelogenous leukemia in a patient with multiple sclerosis. Bone Marrow Transplant 19: 395–397

    Article  CAS  PubMed  Google Scholar 

  7. Mandalfino P, Rice G, Smith A, et al. (2000) Bone marrow transplantation in multiple sclerosis. J Neurol 247:691–695

    Article  CAS  PubMed  Google Scholar 

  8. Hinterberger W, Hinterberger-Fischer M, Marmont A (2002) Clinically demonstrable anti-autoimmunity mediated by allogeneic immune cells favorably affects outcome after stem cell transplantation in human autoimmune diseases. Bone Marrow Transplant 30:753–759

    Article  CAS  PubMed  Google Scholar 

  9. Marmont AM, Gualandi F, Van Lint MT, Bacigalupo A (2003) Refractory Evans’ syndrome treated with allogeneic SCT followed by DLI. Demonstration of a graft-versus-autoimmunity effect. Bone Marrow Transplant 3:399–402

    Article  Google Scholar 

  10. Burt RK, Traynor AE, Craig R, Marmont AM (2003) The promise of hematopoietic stem cell transplantation for autoimmune diseases. Bone Marrow Transplant 3:521–524

    Article  Google Scholar 

  11. Marmont AM (2001) Immunoablation followed or not by hematopoietic stem cells as an intense therapy for severe autoimmune diseases. New perspectives, new problems. Haematologica 86:337–345

    CAS  PubMed  Google Scholar 

  12. Thompson AJ, Montalban X, Barkhof F, et al. (2000) Diagnostic criteria for primary progressive multiple sclerosis: a position paper. Ann Neurol 47:831–835

    Article  CAS  PubMed  Google Scholar 

  13. Kurtzke JF (1983) Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology 33:1444–1452

    CAS  PubMed  Google Scholar 

  14. Filippi M, Rovaris M, Capra R, et al. (1998) A multi-centre longitudinal study comparing the sensitivity of monthly MRI after standard and triple dose gadolinium-DTPA for monitoring disease activity in multiple sclerosis. Implications for phase II clinical trials. Brain 121:2011–2020

    Article  PubMed  Google Scholar 

  15. Perron H, Garson JA, Bedin F, et al. (1997) Molecular identification of a novel retrovirus repeatedly isolated from patients with multiple sclerosis. The Collaborative Research Group on Multiple Sclerosis. Proc Natl Acad Sci U S A 94:7583–7588

    Article  CAS  PubMed  Google Scholar 

  16. Loughran TP Jr, Hadlock KG, Perzova R, et al. (1998) Epitope mapping of HTLV envelope seroreactivity in LGL leukaemia. Br J Haematol 101:318–324

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

We are grateful to Prof. Alberto Marmont for his precious comments and critical revision of the manuscript. We also wish to thank Mrs. Anna Koopmans for her assistance in preparing the manuscript.

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Authors and Affiliations

  1. Centro Trapianti di Midollo Osseo, Centro Regionale Trapianti, Ospedale “R. Binaghi” ASL n° 8, Via Is Guadazzonis, 3, 09126, Cagliari, Italy

    Giorgio La Nasa, Roberto Littera & Licinio Contu

  2. Centro per la Sclerosi Multipla, Dipartimento di Neuroscienze, Università di Cagliari, Cagliari, Italy

    Eleonora Cocco & Maria Giovanna Marrosu

  3. Laboratorio di Neuroimmunologia, IRCCS Santa Lucia, Rome, Italy

    Luca Battistini

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  1. Giorgio La Nasa
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  2. Roberto Littera
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  3. Eleonora Cocco
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  4. Luca Battistini
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  5. Maria Giovanna Marrosu
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  6. Licinio Contu
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Correspondence to Giorgio La Nasa.

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La Nasa, G., Littera, R., Cocco, E. et al. Allogeneic hematopoietic stem cell transplantation in a patient affected by large granular lymphocyte leukemia and multiple sclerosis. Ann Hematol 83, 403–405 (2004). https://doi.org/10.1007/s00277-003-0801-3

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  • DOI: https://doi.org/10.1007/s00277-003-0801-3

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