title: Second transplantation from HLA 2-loci-mismatched mother for graft failure due to hemophagocytic syndrome after cord blood transplantation.
abstract: 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.
authors.affiliation: Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Tanaka
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Matsubara
authors.forename: Souichi
authors.initials: S
authors.lastname: Adachi
authors.forename: Hsi
authors.initials: H
authors.lastname: Chang
authors.forename: Hisanori
authors.initials: H
authors.lastname: Fujino
authors.forename: Yuri
authors.initials: Y
authors.lastname: Higashi
authors.forename: Takahiro
authors.initials: T
authors.lastname: Yasumi
authors.forename: Michihiro
authors.initials: M
authors.lastname: Kobayashi
authors.forename: Ken-ichiro
authors.initials: K
authors.lastname: Watanabe
authors.forename: Munehisa
authors.initials: M
authors.lastname: Takahashi
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Etsuko
authors.initials: E
authors.lastname: Maruya
authors.forename: Hiroh
authors.initials: H
authors.lastname: Saji
authors.forename: Tatsutoshi
authors.initials: T
authors.lastname: Nakahata
mesh_terms: 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
chemical_list: D000900:Anti-Bacterial Agents; D006680:HLA Antigens; D007166:Immunosuppressive Agents