Successful unmanipulated peripheral blood progenitor cell transplantation from an HLA haploidentical 2-locus-mismatched mother in a thalassemic patient with primary graft failure after transplantation of bone marrow and cord blood from unrelated donors.
We report on a boy with beta-thalassemia major who developed early graft failure after double-unit unrelated cord blood transplantation, who subsequently received a myeloablative preconditioning regimen using non-T-cell-depleted PBSCT from his HLA-haploidentical 2-loci-mismatched mother. Neutrophil recovery with full donor chimerism was observed at post-transplantation day +11. Furthermore, GVHD was easy to control. The patient was transfusion-independent with complete donor chimerism eight months post-transplant. The result indicated that fetomaternal microchimerism may be an important attribute of a successful transplant. We suggested that a third allo-HSCT may be taken into consideration for patients with transfusion-dependent thalassemia who experience graft failure, even after two previous transplants.
Jaing
Tang-Her
TH
Department of Pediatrics, Chang Gung Children's Hospital, Chang Gung University, Taoyuan, Taiwan. jaing001@cgmh.org.tw
Sun
Chien-Feng
CF
Lee
Wen-I
WI
Wen
Yu-Chuan
YC
Yang
Chao-Ping
CP
Hung
Iou-Jih
IJ
D016026:Bone Marrow Transplantation; D002675:Child, Preschool; D046528:Chimerism; D036101:Cord Blood Stem Cell Transplantation; D006085:Graft Survival; D006086:Graft vs Host Disease / Q000628:therapy; D006680:HLA Antigens; D006801:Humans; D008297:Male; D036102:Peripheral Blood Stem Cell Transplantation; D014019:Tissue Donors; D017086:beta-Thalassemia / Q000601:surgery*
D006680:HLA Antigens