Successful transplantation of haploidentical CD34+ selected bone marrow cells for an infantile case of severe combined immunodeficiency with aspergillus pneumonia.
A 5-month-old boy with X-linked severe combined immunodeficiency (SCID) and aspergillus pneumonia was successfully transplanted. Before and during transplantation, the patient received O2 administration, systemic amphotericin B, and itraconazole. The transplant was performed with a conditioning regimen of busulfan/cyclophosphamide and 2.9 x 10(6)/kg of CD34+ selected bone marrow cells from his HLA haploidentical mother. Acute grade II graft-versus-host disease (GvHD) was well controlled. Neutrophil counts reached >0.5 x 10(9)/L by day 15 and platelet counts reached > 50 x 10(9)/L by day 48. The T-cell subset (counts) in peripheral blood increased to 42.2% (0.31 x 10(9)/L) by day 46. The pneumonia improved by day 54. The patient has been doing well with limited chronic GvHD of the gut with a follow-up of longer than 40 months after BMT. Conquest of aspergillus pneumonia in SCID infants could be achieved by CD34+ bone marrow cell transplantation together with appropriate anti-fungal treatment.
Yoshihara
Takao
T
Department of Pediatrics, Matsushita Memorial Hospital, Moriguchi-shi, Osaka, Japan.
Morimoto
Akira
A
Nakauchi
Shouhei
S
Fujii
Noriko
N
Tsunamoto
Kentaro
K
Misawa
Akiko
A
Hibi
Shigeyoshi
S
Imashuku
Shinsaku
S
D018952:Antigens, CD34 / Q000032:analysis*; D001228:Aspergillosis / Q000628:therapy*; D001854:Bone Marrow Cells / Q000276:immunology; D016026:Bone Marrow Transplantation; D006650:Histocompatibility Testing; D006801:Humans; D007223:Infant; D008297:Male; D011014:Pneumonia / Q000628:therapy*; D016511:Severe Combined Immunodeficiency / Q000628:therapy*
D018952:Antigens, CD34