Etanercept for treatment of idiopathic pneumonia syndrome after allogeneic hematopoietic stem cell transplantation.

marker because of reported hypermethylation in childhood MDS.3 Our patient initially showed 55.4% CALCA methylation in the peripheral blood, which decreased to 4.5% before the eighth cycle of AC. Importantly, reduction in methylation was not only due to clearance of malignant cells, but was evident in the clone itself.4 Before the third cycle, 58% of cells still carried monosomy 7, but completely methylated alleles were no longer detected (Figure 1). Here we report the first patient with JMML and monosomy 7 treated with AC. The favorable response fits well with previous studies1,2 but has additional remarkable aspects. Thrombocytopenia and HbF at diagnosis indicated that this was a rather aggressive case of JMML.5 Using conventional cytostatic therapy, remissions are rare in these cases6 and disappearance of the monosomy 7 clone in JMML without HSCT has never been reported before. In summary, our results suggest that AC therapy may be a viable option for JMML/monosomy 7 patients, either as a pretransplant window or in the absence of a suitable HSCT donor.