title: Secondary G-CSF mobilized blood stem cell transplantation without preconditioning in a patient with Gaucher disease: Report of a new approach which resulted in complete reversal of severe skeletal involvement.
abstract: Gaucher disease has been treated by allogeneic bone marrow transplantation (BMT), however, severe bone involvement that is probably the most disabling aspect of this disease is difficult to reverse. Other problem of BMT is the use of intensive preconditioning that adversely affects growth and development of the patients. In this study, a patient with type I Gaucher disease was treated by allogeneic BMT from HLA-matched sibling donor. However, the treatment resulted in late graft failure and the patient developed severe bone involvement. Fifty months after the first BMT, the patient was treated by allogeneic peripheral blood stem cell (PBSC) transplantation without preconditioning. Recombinant human granulocyte-colony stimulating factor (rhG-CSF) was used to mobilize PBSC. Cyclosporine A (CyA) was administered for the prophylaxis of graft-versushost disease (GVHD). Full donor-derived hematopoiesis was obtained, and clinical symptoms including severe bone involvement improved completely with increased glucocerebrosidase activity. It was shown that an engraftment could be obtained without intensive preconditioning when a recipient receives an rhG-CSF-mobilized PBSCs infusion as a secondary transplant. Another important finding of this study is the complete reversal of severe bone involvement by the supply of abundant glucocerebrosidase from high proliferating PBSC graft.
authors.affiliation: Specialized Clinical Science, Pediatrics, Tokai University School of Medicine, Bohseidai, Isehara, Kanagawa 259-1193, Japan. yabeh@is.icc.u-tokai.ac.jp
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Yabe
authors.forename: Miharu
authors.initials: M
authors.lastname: Yabe
authors.forename: Kinya
authors.initials: K
authors.lastname: Hattori
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Inoue
authors.forename: Masae
authors.initials: M
authors.lastname: Matsumoto
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hamanoue
authors.forename: Aiko
authors.initials: A
authors.lastname: Hiroi
authors.forename: Takashi
authors.initials: T
authors.lastname: Koike
authors.forename: Shunichi
authors.initials: S
authors.lastname: Kato
mesh_terms: D016026:Bone Marrow Transplantation; D002675:Child, Preschool; D005260:Female; D005776:Gaucher Disease / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D005962:Glucosylceramidase / Q000378:metabolism; D016179:Granulocyte Colony-Stimulating Factor / Q000494:pharmacology*; D019650:Hematopoietic Stem Cell Mobilization; D006801:Humans; D036102:Peripheral Blood Stem Cell Transplantation / Q000379:methods*; D011859:Radiography; D012784:Shoulder Fractures / Q000150:complications* / Q000000981:diagnostic imaging; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous
chemical_list: D016179:Granulocyte Colony-Stimulating Factor; D005962:Glucosylceramidase