Imminent allograft rejection prevented by donor lymphocyte transfusions: report of two pediatric cases.
Gradual allograft rejection after initial good engraftment may occur with simultaneous autologous reconstitution particularly in patients receiving nonmyeloablative conditioning. Careful post-transplant follow-up of the chimerism status can reveal these cases early on, when the immunological balance may still be shifted to the donor cells. We describe two children with nonmalignant diseases, in whom imminent rejection of their sibling allografts was prevented with donor lymphocyte transfusions (DLT). DLT dosing and timing need to be individually guided by monitoring of the chimerism status.
Saarinen-Pihkala
U M
UM
Hospital for Children and Adolescents, University of Helsinki, Finland.
Taskinen
M
M
Vettenranta
K
K
Hovi
L
L
D002648:Child; D002675:Child, Preschool; D006084:Graft Rejection / Q000175:diagnosis / Q000517:prevention & control*; D006402:Hematologic Diseases / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods; D006801:Humans; D007107:Immune System / Q000502:physiology; D017710:Lymphocyte Transfusion; D008297:Male; D012038:Regeneration; D018183:Transplantation Chimera; D014184:Transplantation, Homologous