Second transplantation from HLA 2-loci-mismatched mother for graft failure due to hemophagocytic syndrome after cord blood transplantation.
A 7-year-old girl with acute myelogenous leukemia with multilineage dysplasia received unrelated cord blood transplantation but developed hemophagocytic syndrome (HPS) after sepsis with methicillin-resistant coagulase-negative staphylococci before engraftment. Bone marrow aspiration on day 20 revealed a markedly increased number of activated macrophages showing hemophagocytosis. The presence of donor-type chimera in the bone marrow was confirmed at that time. We therefore quickly started immunosuppressive and antibacterial treatment. Although her condition gradually improved, the patient suffered graft failure due to HPS. She received peripheral blood stem cell transplantation from her HLA 2-loci-mismatched mother on day 54 and continued in complete remission 12 months after the second transplantation. The results in this case suggested that because of fetomaternal microchimerism it may be useful to select an HLA-haploidentical mother as a backup donor for stem cell transplantation.
Tanaka
Takayuki
T
Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Matsubara
Hiroshi
H
Adachi
Souichi
S
Chang
Hsi
H
Fujino
Hisanori
H
Higashi
Yuri
Y
Yasumi
Takahiro
T
Kobayashi
Michihiro
M
Watanabe
Ken-ichiro
K
Takahashi
Munehisa
M
Kobayashi
Yoshiro
Y
Maruya
Etsuko
E
Saji
Hiroh
H
Nakahata
Tatsutoshi
T
D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D002648:Child; D036101:Cord Blood Stem Cell Transplantation; D005260:Female; D006084:Graft Rejection / Q000209:etiology / Q000473:pathology; D006086:Graft vs Host Disease / Q000150:complications* / Q000473:pathology; D006680:HLA Antigens; D015616:Histiocytosis, Non-Langerhans-Cell / Q000188:drug therapy / Q000209:etiology / Q000473:pathology; D006650:Histocompatibility Testing; D006801:Humans; D007166:Immunosuppressive Agents; D015470:Leukemia, Myeloid, Acute / Q000473:pathology / Q000628:therapy*; D036102:Peripheral Blood Stem Cell Transplantation; D018183:Transplantation Chimera
D000900:Anti-Bacterial Agents; D006680:HLA Antigens; D007166:Immunosuppressive Agents