Transplantation of CD34-enriched peripheral stem cells from an HLA-haplotype mismatched donor to a patient with severe aplastic anemia.
A 14-year-old girl developed very severe aplastic anemia unresponsive to steroids, cyclosporine, ATG and filgrastim. She experienced repeated bacterial infections, hypermenorrhagia and epistaxis and received numerous transfusions. Lacking a matched family or unrelated donor, she was transplanted 6 months after diagnosis with CD34+ cell-enriched peripheral stem cells from her HLA-haploidentical uncle. Conditioning included fludarabine, cyclophosphamide, 800 cGy TLI and OKT3. Prompt and sustained trilineage engraftment occurred. Acute GVHD grade 1 and herpes esophagitis were successfully treated. Eight months after grafting she was well with stable hematopoiesis. She then succumbed to fulminant hepatic failure due to adenovirus infection.
Kremens
B
B
Departments of Pediatric Hematology-Oncology and Endocrinology, West German Tumor Center, University Hospital, Essen, Germany.
Basu
O
O
Grosse-Wilde
H
H
Sauerwein
W
W
Schaefer
U W
UW
Havers
W
W
D000257:Adenoviridae Infections / Q000209:etiology; D000293:Adolescent; D000741:Anemia, Aplastic / Q000150:complications / Q000628:therapy*; D018952:Antigens, CD34 / Q000097:blood*; D005260:Female; D006085:Graft Survival; D006239:Haplotypes / Q000276:immunology*; D006410:Hematopoiesis; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods; D006650:Histocompatibility Testing / Q000592:standards; D006801:Humans; D017093:Liver Failure / Q000821:virology; D013234:Stem Cells / Q000276:immunology*; D019172:Transplantation Conditioning
D018952:Antigens, CD34