Unusual extramedullary recurrences and breast relapse despite hepatic GVHD after allografting in Ph⁺-ALL

Ebru KocaDivision of HematologyDepartment of Internal Medicine, Hacettepe University, Ankara, Turkey

Hakan GokerDivision of HematologyDepartment of Internal Medicine, Hacettepe University, Ankara, Turkey

Gulay S. GuvenDepartment of Internal MedicineHacettepe University, Ankara, Turkey

Deniz CetinerDivision of HematologyDepartment of Internal Medicine, Hacettepe University, Ankara, Turkey

Ibrahim C. HaznedarogluDivision of HematologyDepartment of Internal Medicine, Hacettepe University, Ankara, Turkey

Yahya BuyukasikDivision of HematologyDepartment of Internal Medicine, Hacettepe University, Ankara, Turkey

Aysegul UnerDepartment of PathologyHacettepe University, Ankara, Turkey

Osman I. OzcebeDivision of HematologyDepartment of Internal Medicine, Hacettepe University, Ankara, Turkey

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Abstract

Extramedullary recurrences with or without bone marrow involvement are reported in up to a half of leukemic relapses after BMT. Our report describes a case of an extramedullary recurrence and breast relapse after second-allografting in a female patient with Ph⁺-acute lymphoblastic leukemia (ALL), occurring when there was active hepatic GHVD. This case illustrates the complex relationship between graft-versus-host disease (GVHD) and graft-versus-leukemia since she had no evidence of leukemia in her marrow demonstrating 100% full-donor chimerism while she had ALL relapse in her breast.

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Unusual extramedullary recurrences and breast relapse despite hepatic GVHD after allografting in Ph⁺-ALL

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Unusual extramedullary recurrences and breast relapse despite hepatic GVHD after allografting in Ph+-ALL

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Unusual extramedullary recurrences and breast relapse despite hepatic GVHD after allografting in Ph⁺-ALL