Evidence of induced non-tolerance in HLA-identical twins with hemoglobinopathy after in utero fetal transplantation.
Fetus-to-fetus transplantation has been suggested for the treatment of hemoglobinopathies in utero. However, dissimilar results have to date been obtained by different groups. We describe a case in which fetus-to-fetus transplantation in HLA-identical twins was performed at the 19th week of gestation by infusion of 0.8 ml of fetal blood from normal to beta-thalassemia affected fetus with the main aim of inducing tolerance. No evidence of engraftment, determined by KM19 polymorphism, was present after 2 years of the procedure. Moreover, an alloreactive cytotoxic T lymphocyte precursor (CTLp) study of affected fetus vs donor and other different stimulators showed that immunization vs tolerance was the real effect of the procedure.
Orlandi
F
F
Servizio Talassemia e Diagnosi Prenatale, Unita' di Ricerca Piera Cutino, Ospedale V Cervello, Palermo, Italy.
Giambona
A
A
Messana
F
F
Marino
M
M
Abate
I
I
Calzolari
R
R
Damiani
F
F
Jakil
C
C
Renda
M
M
Dieli
F
F
Buscemi
F
F
Westgren
M
M
Ringden
O
O
Maggio
A
A
D000293:Adolescent; D005260:Female; D005330:Fetofetal Transfusion; D006650:Histocompatibility Testing; D006801:Humans; D007108:Immune Tolerance; D011247:Pregnancy; D013602:T-Lymphocytes, Cytotoxic / Q000276:immunology; D017086:beta-Thalassemia / Q000628:therapy*