Successful treatment with T-depleted autologous peripheral blood stem cell transplantation of refractory chronic autoimmune thrombocytopenic purpura.
Autoimmune thrombocytopenia (AITP) is a disorder due to specific platelet auto-antibodies directed against platelet surface glycoproteins. AITP in adults is usually chronic, idiopathic and frequently refractory to conventional treatments. Myelo- and immuno-suppressive chemotherapy followed by autologous peripheral blood stem cell (PBSC) transplantation is an experimental approach for severe chronic refractory AITP. We report a case of a woman with AITP, refractory to the conventional therapy, submitted to T-cell-depleted autologous PBSC transplantation, which obtained long term stable response on platelet count. We deem that the positive outcome of our patient depends on T-cells depletion of the graft, which reduces autoreactive T clones.
Elli
E
E
Divisione di Ematologia e Unità Trapianto, Ospedale San Gerardo di Monza, Università degli Studi di Milano-Bicocca, 20052 Monza, Italy. elena.elli@libero.it
Parma
M
M
Perseghin
P
P
Dassi
M
M
Terruzzi
E
E
Belotti
D
D
Pioltelli
P
P
Poglian
E M
EM
D019072:Antibiotic Prophylaxis; D003131:Combined Modality Therapy; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008212:Lymphocyte Depletion; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000188:drug therapy / Q000601:surgery*; D012074:Remission Induction; D013156:Splenectomy; D013601:T-Lymphocytes / Q000276:immunology; D019172:Transplantation Conditioning; D014182:Transplantation, Autologous
D016756:Immunoglobulins, Intravenous; D007166:Immunosuppressive Agents; D016179:Granulocyte Colony-Stimulating Factor