Novel adopted immunotherapy for mixed chimerism after unrelated cord blood transplantation in Omenn syndrome.
Omenn syndrome is a variant form of severe combined immunodeficiency. It is fatal unless treated by allogeneic stem cell transplantation (SCT), which is the only curative approach. However, both treatment-related complications and graft rejection are major obstacles to treatment success. This report describes a case with Omenn syndrome who developed mixed chimerism after unrelated cord blood transplantation (UCBT). This case was successfully treated by altering the patient's immunosuppression and donor lymphocyte infusion (DLI) with donor cord blood-derived activated CD4+ T cells ex vivo expanded from the cord blood cell residues in an infused bag. This novel development to expand CD4+ T-lymphocytes from the donor cord blood unit for the use of DLI would serve as a useful method to overcome the risk of graft rejection in SCT for primary immunodeficiency disorders with residual cell-mediated immunity without compounding graft-vs.-host disease, especially in the UCBT setting.
Tomizawa
Daisuke
D
Department of Pediatrics and Developmental Biology, Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, Japan.
Aoki
Yuki
Y
Nagasawa
Masayuki
M
Morio
Tomohiro
T
Kajiwara
Michiko
M
Sekine
Teruaki
T
Shimizu
Norio
N
Kato
Masahiko
M
Yachie
Akihiro
A
Mizutani
Shuki
S
D015496:CD4-Positive T-Lymphocytes / Q000637:transplantation; D036101:Cord Blood Stem Cell Transplantation; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007167:Immunotherapy / Q000379:methods*; D007223:Infant; D017710:Lymphocyte Transfusion; D008297:Male; D016511:Severe Combined Immunodeficiency / Q000628:therapy*; D013577:Syndrome; D018183:Transplantation Chimera; D016896:Treatment Outcome
D007166:Immunosuppressive Agents