Donor lymphocyte infusions for refractory pure red cell aplasia relapsing after both autologous and nonmyeloablative allogeneic peripheral stem cell transplantation.
Pure red cell aplasia (PRCA) is characterized by a selective marrow aplasia of the erythroid compartment. Immunosuppressive therapy achieves good results in about 25% of cases, but relapses are frequent. Autologous or allogeneic haematopoietic stem cell transplantation (HSCT) may be valuable in selected patients. Here, we report details of a 29-year-old woman treated successfully by donor lymphocyte infusions (DLIs) following allogeneic HSCT for acquired refractory relapsed PRCA. The nonmyeloablative conditioning regimen consisted of cyclophosphamide 60 mg/kg/day for 2 days and fludarabine 30 mg/m(2) daily for 4 days. Haematopoiesis was still completely 'recipient' 1 month after allo-HSCT, but progressed to full donor engraftment after three doses of 'escalating' DLI. The possible role of a graft-versus-autoimmunity effect induced by allogeneic HSCT followed by DLI infusions in the treatment of the disease is discussed.
Musso
M
M
UO Oncoematologia e Trapianto di Midollo, Dipartimento Oncologico, La Maddalena, Palermo, Italy. mamusso@libero.it
Porretto
F
F
Crescimanno
A
A
Polizzi
V
V
Scalone
R
R
D000328:Adult; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D017710:Lymphocyte Transfusion; D036102:Peripheral Blood Stem Cell Transplantation; D012008:Recurrence; D012010:Red-Cell Aplasia, Pure / Q000628:therapy*; D012074:Remission Induction / Q000379:methods; D016879:Salvage Therapy / Q000379:methods*; D018183:Transplantation Chimera; D019172:Transplantation Conditioning / Q000379:methods; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous