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Table 1 Clinical Course of Patient

From: 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

Dates (Time from transplant) March 2009 At Diagnosis February 2010 (Day 100) September 2010 (10 Months) October 2010 (11 Months) December 2010 -January 2011 (14 Months) February 2011 (15 Months) April 2011 (17 Months) June 2011- October 2011 (19–24 Months)
Bone Marrow Biopsy Morphology Hypercellular 90% with 56% B-Lymphoblasts No evidence of disease Not done No evidence of disease Recurrent disease comprising 71% of total cells Residual disease 4.4% CD34+ TDT + Blasts No evidence of residual/recurrent disease No evidence of residual/ recurrent disease
Donor Chimerism BM/PB N/A Female recipient 100% male donor by chromosomes and STR (BM) Not done 100% male donor 12% male donor 100% male donor Not done 100% male donor
FISH/ PCR BCR/ABL Blood or Bone Marrow Philadelphia Chromosome Positive Negative for BCR/ABL translocation by RT-PCR (BM) Negative for BCR/ABL translocation (PB) Positive minor breakpoint .014% FISH positive BCR/ABL; RT PCR positive for the minor breakpoint region 39.22% 4.4 percent by FISH analysis Negative for BCR/ABL translocation by RT-PCR Negative for BCR/ABL translocation
TKI treatment N/A None Gleevec 100 mg* Gleevec 100 mg* Nilotinib (400 mg po bid started) Nilotinib (400 mg po bid) Nilotinib 800 mg (400 mg po bid) Nilotinib (400 mg po bid)
GVHD N/A skin and gut skin skin skin skin, eyes, mouth, and gut skin, eyes, mouth, and gut skin, eyes, mouth, and gut
ECP N/A None None None None None None ECP **
IST N/A Cyclosporine and Prednisone Cyclosporine and Prednisone Weaned Discontinued Cyclosporine: 125 mg p.o.b.i.d. Cyclosporine: 150 mg p.o.b.i.d. CellCept: 1000 mg p.o.b.i.d.
       Prednisone: 25 mg daily   Prednisone: 10 mg
  1. * The patient was unable to tolerate a higher dose of Gleevec due to low platelet counts.
  2. **ECP treatments- Treatments were scheduled bi weekly for eight weeks, then once every two weeks for eight weeks, then once a month.
  3. BM bone marrow.
  4. PB peripheral blood.
  5. FISH fluorescent in situ hybridization.
  6. PCR polymerase chain reaction; RT-PCR reverse transcription polymerase chain reaction.
  7. TKI tyrosine-kinase inhibitor.
  8. GVHD graft-versus-host disease.
  9. ECP extracorporeal photopheresis.
  10. IST immunosuppressive therapy.