Background <p>Fanconi anemia (FA) is a rare inherited disorder characterized by genomic instability, bone marrow failure, and a markedly increased risk of developing acute myeloid leukemia (AML). The intrinsic hypersensitivity of FA cells to DNA-damaging agents renders conventional chemotherapy particularly toxic and often ineffective.</p> Case Presentation <p>A 31-year-old woman with FA who progressed to AML and failed to achieve remission with standard induction therapy. Bone marrow blasts were initially 10%.</p> Intervention <p>As part of a clinical trial, she received CD56<sup>+</sup> cell-based immunotherapy after FLAG chemotherapy. She subsequently underwent allogeneic hematopoietic stem cell transplantation (HSCT) from a matched sibling donor using a CD3<sup>+</sup>/CD19-depleted graft. Post-transplant, she received additional infusions of CD56<sup>+</sup> cells.</p> Outcome <p>CD56<sup>+</sup> immunotherapy reduced bone marrow blasts from 10 to 3%, enabling successful HSCT. Post-transplant, she remained in complete remission with no detectable minimal residual disease (MRD) at both day +30 and day +90.</p> Conclusion <p>CD56<sup>+</sup> cell-based immunotherapy can effectively decrease the leukemic burden in FA patients with AML, facilitating successful HSCT. This innovative approach may enhance outcomes for high-risk patients and merits further research.</p>

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Allogeneic CD56+ cell-based immunotherapy in a patient with Fanconi anemia developing acute myeloid leukemia

  • Mehdi Bakhtiyari Dovvombaygi,
  • Amin Shahbaz Ghasabeh,
  • Shiva Eskandarian,
  • Amirhossein Izadpanah,
  • Seyed Mehrab Safdari,
  • Sahar Parkhideh,
  • Mehrshad Seresht-Ahmadi,
  • Abbas Hajifathali,
  • Elham Roshandel

摘要

Background

Fanconi anemia (FA) is a rare inherited disorder characterized by genomic instability, bone marrow failure, and a markedly increased risk of developing acute myeloid leukemia (AML). The intrinsic hypersensitivity of FA cells to DNA-damaging agents renders conventional chemotherapy particularly toxic and often ineffective.

Case Presentation

A 31-year-old woman with FA who progressed to AML and failed to achieve remission with standard induction therapy. Bone marrow blasts were initially 10%.

Intervention

As part of a clinical trial, she received CD56+ cell-based immunotherapy after FLAG chemotherapy. She subsequently underwent allogeneic hematopoietic stem cell transplantation (HSCT) from a matched sibling donor using a CD3+/CD19-depleted graft. Post-transplant, she received additional infusions of CD56+ cells.

Outcome

CD56+ immunotherapy reduced bone marrow blasts from 10 to 3%, enabling successful HSCT. Post-transplant, she remained in complete remission with no detectable minimal residual disease (MRD) at both day +30 and day +90.

Conclusion

CD56+ cell-based immunotherapy can effectively decrease the leukemic burden in FA patients with AML, facilitating successful HSCT. This innovative approach may enhance outcomes for high-risk patients and merits further research.