Long-term remission after fetal liver transplantation in acute leukemia: a 30-year follow-up report of two cases

Abstract

Abstract Fetal liver hematopoietic stem cells (HSCs) have the capacity to temporarily engraft, thereby facilitating the reconstitution of hematopoiesis without severe graft-versus-host disease (GVHD). In two cases of acute leukemia, the patients underwent fetal liver transplantation (FLT), receiving cells from multiple donors at doses ranging from 7.02 to 8.3 × 10^8 cells/kg, following an intensive conditioning regimen in 1983 and 1985. Remarkably, both individuals have since achieved sustained complete remission and hematopoietic recovery, and have maintained a normal life for over three decades. Although FLT is no longer a viable clinical option, the positive outcomes of these cases are noteworthy and are shared herein. Our findings underscore the potential of FLT to offer short-term hematopoietic support, contributing to the recovery of patients with acute leukemia and may inspire research into ideal HSCs that emulate the characteristics of fetal liver cells for future transplantation applications.

Keywords

• Fetal liver transplantation (FLT)
• Acute leukemia
• Hematopoietic stem cells (HSCs)
• Graft-versus-host disease (GVHD)
• Long-term remission