Unrelated partially matched lymphocyte infusions in a patient with complete DiGeorge/CHARGE syndrome.
We present an infant with cDGS overlapping with CHARGE syndrome, who suffered from T-cell deficiency treated with screened healthy DLI from an unrelated donor (8/10 match). The first dose of DLI (1.1 x 10(6) CD3+/kg) was administered at the age of six months, the second one (0.9 x 10(6) CD3+/kg) 36 days later. No conditioning was employed, GvHD prophylaxis consisting of CsA was used only during the second infusion. Since day+10 after the first DLI, split chimerism showing T-cell engraftment has been documented. Proliferative response to PHA was detected on day+145. The treatment was complicated by severe acute GvHD (grade II-III) after the first DLI and prolonged chronic liver cholestatic GvHD developing after the second DLI. Vigorous EBV proliferation four wk after the second DLI was accompanied by peripheral expansion of CD8+ donor cells. The patient, 26-months old, is clinically well and has slowly started to gain his developmental milestones. We believe that infusions of small doses of DLI from an unrelated donor represent a potentially helpful therapeutic option in patients with cDGS/CHARGE phenotype.
Janda
Ales
A
Deptartment of Immunology, University Hospital Motol, Prague, Czech Republic. ales.janda@lfmotol.cuni.cz
Sedlacek
Petr
P
Mejstrikova
Ester
E
Zdrahalova
Katerina
K
Hrusak
Ondrej
O
Kalina
Tomas
T
Sieglova
Zuzana
Z
Zizkova
Hana
H
Formankova
Renata
R
Keslova
Petra
P
Hubacek
Petr
P
Sediva
Anna
A
Bartunkova
Jirina
J
Dlask
Karel
K
Stary
Jan
J
D001006:Anus, Imperforate / Q000628:therapy; D003103:Coloboma / Q000628:therapy*; D004062:DiGeorge Syndrome / Q000097:blood / Q000628:therapy*; D004423:Ear / Q000002:abnormalities; D004427:Ear Diseases / Q000151:congenital / Q000628:therapy; D005500:Follow-Up Studies; D005837:Genitalia, Male / Q000002:abnormalities; D006086:Graft vs Host Disease / Q000209:etiology / Q000517:prevention & control; D006130:Growth Disorders / Q000628:therapy; D006330:Heart Defects, Congenital / Q000628:therapy; D006801:Humans; D007231:Infant, Newborn; D008607:Intellectual Disability / Q000628:therapy; D017710:Lymphocyte Transfusion / Q000009:adverse effects / Q000379:methods*; D008297:Male; D013601:T-Lymphocytes