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.
Departments of Pediatric Hematology-Oncology and Endocrinology, West German Tumor Center, University Hospital, Essen, Germany.
B
B
Kremens
O
O
Basu
H
H
Grosse-Wilde
W
W
Sauerwein
U W
UW
Schaefer
W
W
Havers
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