Primary graft failure after umbilical cord blood transplant rescued by parental haplocompatible stem cell transplantation.
AB Graft failure and aplasia are known complications of umbilical cord blood (UCB) hematopoietic stem cell transplantation (HSCT). In the absence of a second HSCT, graft failure is generally a fatal complication due to overwhelming infection. We describe 2 children with primary graft failure and life-threatening infections after UCB HSCT who were rescued by the use of related haplocompatible T-cell-depleted peripheral blood stem cell transplants. The rapid availability of haplocompatible donors and the brisk neutrophil recovery after haplocompatible peripheral blood stem cell transplant with high numbers of CD34+ cells make this an attractive rescue strategy for patients with graft failure after UCB HSCT.
Division of Pediatric Blood and Marrow Transplant, UCSF Children's Hospital, University of California, San Francisco, CA, USA. dvorakc@peds.ucsf.edu
Christopher C
CC
Dvorak
Andrew L
AL
Gilman
Biljana
B
Horn
Morton J
MJ
Cowan
D000328:Adult; D053687:Adult Stem Cells / Q000637:transplantation*; D023201:CD40 Ligand / Q000235:genetics; D002675:Child, Preschool; D036101:Cord Blood Stem Cell Transplantation / Q000009:adverse effects*; D006085:Graft Survival; D018380:Hematopoietic Stem Cell Transplantation; D006648:Histocompatibility; D006801:Humans; D007938:Leukemia / Q000628:therapy*; D008297:Male; D009504:Neutrophils / Q000166:cytology; D010290:Parents
D023201:CD40 Ligand