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Acute "Graft-Versus-Host Disease" After Autografting for Chronic Granulocytic Leukemia in Transformation

SWEE LAY THEIN, B.M., B.S.; JOHN M. GOLDMAN, B.M.; and DAVID A. G. GALTON, M.D.
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▸Requests for reprints should be addressed to John M. Goldman, B.M.; Royal Postgraduate Medical School, Hammersmith Hospital, Ducane Road; London W12 OHS, United Kingdom.


Hammersmith Hospital and Royal Postgraduate Medical School; London, England


Ann Intern Med. 1981;94(2):210-211. doi:10.7326/0003-4819-94-2-210
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Four cases of acute graft-versus-host disease have now been reported in patients who have received transplants of syngeneic bone marrow (1, 2). This phenomenon could be explained if graft-versus-host disease were due to an imbalance of lymphocyte subsets regardless of donor-recipient histocompatibility (3). We have recently seen a patient with chronic granulocytic leukemia in transformation who developed a syndrome resembling acute

Figure 1. Clinical and hematological course of patient with "graft-versus-host disease." DNR = daunorubicin; Ara-C = cytarabine; 6TG = 6-thioguanine; platelets = donor platelet transfusions (irradiated to 1500 rad); WBC = donor granulocyte transfusions (irradiated to 1500 rad); Hb = hemoglobin; BM = bone marrow biopsies; CP = chronic phase.

graft-versus-host disease after autografting with stored buffy-coat leukocytes.

A 23-year-old woman was found to have Philadelphia-chromosome-positive chronic granulocytic leukemia in August 1978. Peripheral blood cells were collected by leukapheresis and cryopreserved. She was treated with busulphan, and splenectomy was

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