Successful non-T cell-depleted HLA haplo-identical three-loci mismatched hematopoietic stem cell transplantation from mother to son based on the feto-maternal microchimerism in chronic myelogenous leukemia.
A 17-year-old male with chronic myelogenous leukemia in blast crisis received a non-T cell-depleted (TCD) HLA haplo-identical three-loci mismatched hematopoietic stem cell transplant (HSCT) from his mother. Long-term feto-maternal microchimerism was detected by nested polymerase chain reaction with sequence-specific primer typing. The post-transplantation prophylaxis against graft-versus-host disease (GVHD) was tacrolimus with minidose methotrexate. Sustained engraftment was obtained. Acute GVHD (grade 2) developed, but improved rapidly. Bone marrow aspiration on day 120 showed complete remission. Non-TCD HLA haplo-identical HSCT based on feto-maternal microchimerism might be feasible and has important implications in the selection of alternative family donors in HSCT.
Ochiai
N
N
Second Department of Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Shimazaki
C
C
Fuchida
S
S
Okano
A
A
Sumikuma
T
T
Ashihara
E
E
Inaba
T
T
Fujita
N
N
Maruya
E
E
Nakagawa
M
M
D000293:Adolescent; D005260:Female; D006086:Graft vs Host Disease / Q000188:drug therapy / Q000517:prevention & control; D006239:Haplotypes; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006648:Histocompatibility; D006650:Histocompatibility Testing; D006801:Humans; D007108:Immune Tolerance; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000150:complications / Q000628:therapy*; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D009679:Nuclear Family; D016559:Tacrolimus / Q000627:therapeutic use; D018183:Transplantation Chimera; D016896:Treatment Outcome
D016559:Tacrolimus; D008727:Methotrexate