Transplantation of incompatible bone marrow in infants with severe combined immunodeficiency disease.
Our efforts to overcome the fatal GVH disease following transplantation of incompatible bone marrow have been: 1) isolation of patient in sterile laminar flow room, 2) elimination of bacterial flora from GI tract, 3) repeated infusions of plasma containing blocking antibodies, 4) selection of HL-A identical but unrelated donor from general population, 5) use of stem-cell fraction of bone marrow and 6) gradual transplantation of marrow (less than 0.01 ml) carefully aspirated, free of immunocompetent T-cell contamination. A mild form of GVH disease, partial reconstitution of immune function and hematologic chimera were noted in 2 patients, who survived 67 days and 125 days after transplantation. More recently, an infant with severe combined immunodeficiency disease (SCID) has been reconstituted immunologically using marrow from HL-A mismatched, mixed leukocytes culture (MLC) non-reactive donor. The gradual transplantation method may be a useful means of transplanting incompatible marrow in infants with SCID.
D000917:Antibody Formation; D001803:Blood Transfusion; D001854:Bone Marrow Cells; D016026:Bone Marrow Transplantation; D002180:Candidiasis, Oral / Q000209:etiology; D005260:Female; D006087:Graft vs Host Reaction; D006648:Histocompatibility; D006801:Humans; D007111:Immunity, Cellular; D005779:Immunodiffusion; D007153:Immunologic Deficiency Syndromes / Q000628:therapy*; D007223:Infant; D008213:Lymphocyte Activation; D007959:Lymphocyte Culture Test, Mixed; D008297:Male; D010357:Patient Isolators; D010949:Plasma; D012131:Respiratory Insufficiency / Q000209:etiology; D012882:Skin Tests