Successful non-T-cell-depleted HLA-haploidentical 3-loci mismatched bone marrow transplantation.
A 17-year-old boy with therapy-related acute myelocytic leukemia (FAB classification-M0) successfully received allogeneic non-T-cell depleted (non-TCD) bone marrow transplantation (BMT) from his 3-loci HLA-mismatch mother, although pre-BMT detection of feto-maternal microchimerism was negative. The BMT was performed with reduced intensity conditioning (total body irradiation; 4 Gy, fludarabine; 20 mg/m(2) x 6, and melphalan; 70 mg/m(2) x 2) and short-course methotrexate and tacrolimus for GVHD prophylaxis. Complete donor chimera was obtained on day 19, associated with Grade 3 acute GVHD (skin: Stage 1, liver: Stage 0, gut: Stage 3) that was well controlled with immunosuppressive therapies. At day 200 of transplantation, he was in complete remission with no signs of chronic GVHD. Our case suggests that non-TCD HLA-haploidentical 3-loci mismatched BMT can be safely performed from mother to offspring even when feto-maternal microchimerism is barely detectable with the current detection procedure.
Yagyu
Shigeki
S
Department of Pediatrics, Kyoto City Hospital, Kyoto, Japan. shigeky@m7.dion.ne.jp
Kuroda
Hiroshi
H
Fujiki
Atsushi
A
Tamura
Shinichi
S
Iehara
Tomoko
T
Morimoto
Akira
A
Hosoi
Hajime
H
Sugimoto
Tohru
T
Imashuku
Shinsaku
S
D000293:Adolescent; D016026:Bone Marrow Transplantation; D005260:Female; D006086:Graft vs Host Disease / Q000473:pathology / Q000517:prevention & control; D006680:HLA Antigens; D006650:Histocompatibility Testing; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000628:therapy*; D008297:Male; D033261:Maternal-Fetal Relations; D009035:Mothers; D012074:Remission Induction; D014019:Tissue Donors; D018183:Transplantation Chimera; D019172:Transplantation Conditioning
D006680:HLA Antigens