title: [Infantile T cell acute lymphoblastic leukemia complicated by thrombotic microangiopathy and human herpes virus 6 infection after allogeneic peripheral blood stem cell transplantation using CD34-positive cells].
abstract: We report on a 19-month-old boy with refractory T-cell acute lymphoblastic leukemia who underwent allogeneic peripheral blood stem cell transplantation using positively selected CD34 cells from his HLA two-loci mismatched mother. The conditioning regimen consisted of busulfan (140 mg/m2/d for 2 days), total body irradiation (12 Gy) and melphalan (210 mg/m2). The patient received cyclosporin A for graft-versus-host disease (GVHD) prophylaxis. The CD34-positive cells were separated using an immunomagnetic cell-separation system (Isolex 50). The number of infused CD34-positive cells was 4.4 x 10(6)/kg. Successful engraftment was confirmed on day 14 by fluorescent in situ hybridization of X chromosomes. The patient experienced severe diarrhea due to thrombotic microangiopathy (TMA) following acute GVHD, and died on day 71 of human herpes virus type 6 pneumonitis. Stem cell transplantation using CD34 positively selected cells from HLA-mismatched related donors may be a useful treatment with low incidence of severe GVHD, but many problems remain to be overcome, including severe viral infections and TMA.
authors.affiliation: Department of Pediatrics, Kobe University School of Medicine.
authors.forename: D
authors.initials: D
authors.lastname: Hasegawa
authors.forename: K
authors.initials: K
authors.lastname: Sano
authors.forename: Y
authors.initials: Y
authors.lastname: Kosaka
authors.forename: A
authors.initials: A
authors.lastname: Hayakawa
authors.forename: R
authors.initials: R
authors.lastname: Kawagoe
authors.forename: K
authors.initials: K
authors.lastname: Amo
authors.forename: K
authors.initials: K
authors.lastname: Taya
authors.forename: N
authors.initials: N
authors.lastname: Hirabayashi
authors.forename: H
authors.initials: H
authors.lastname: Nakamura
mesh_terms: D018952:Antigens, CD34; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006566:Herpesviridae Infections / Q000209:etiology*; D015654:Herpesvirus 6, Human; D006801:Humans; D007223:Infant; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000150:complications* / Q000628:therapy; D008297:Male; D013927:Thrombosis / Q000209:etiology* / Q000473:pathology
chemical_list: D018952:Antigens, CD34