[Chronic graft-versus-host disease with multiple serositis after bone marrow transplantation from non-inherited maternal antigen-complementary sibling donor].
We report a patient who developed multiple serositis during chronic graft-versus-host disease (GVHD) after allogeneic bone marrow transplantation from a non-inherited maternal antigen (NIMA) -complementary sibling donor. The patient was a 9-year-old boy with myelodysplastic syndrome, who urgently underwent bone marrow transplantation from his NIMA-complementary HLA two-locus-mismatched sister following graft failure of cord blood transplantation. Engraftment was successfully confirmed and no acute GVHD developed. After withdrawal of tacrolimus to prevent recurrent viral infection, he developed pleural effusion, ascites and edema approximately 6 months after transplantation. His clinical symptoms were resolved by methylprednisolone pulse therapy, but he subsequently progressed to develop pericardial effusion, pneumothorax and truncal panniculitis. Pleural and pericardial effusion contained numerous lymphocytes, which gradually subsided with continuous drainage. His symptoms were thereafter controlled by the addition of mycophenolate mofetil (MMF) administration, and his current performance status is almost perfect by the administration of prednisolone (5 mg/day) and MMF at 6 years after transplantation. Although multiple serositis associated with GVHD is known to have a poor prognosis, the multiple symptoms of this patient improved gradually, probably owing to a lack of acute GVHD and the effect of MMF.
Akahane
Koshi
K
Department of Pediatrics, Faculty of Medicine, University of Yamanashi.
Inukai
Takeshi
T
Nemoto
Atsushi
A
Kuroda
Itaru
I
Minai
Amane
A
Hirose
Kinuko
K
Honna
Hiroko
H
Goi
Kumiko
K
Sugita
Kanji
K
D000293:Adolescent; D016026:Bone Marrow Transplantation; D002648:Child; D002908:Chronic Disease; D004322:Drainage; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology / Q000628:therapy*; D006680:HLA Antigens; D006648:Histocompatibility; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D008297:Male; D009173:Mycophenolic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives; D009190:Myelodysplastic Syndromes / Q000628:therapy*; D012700:Serositis / Q000209:etiology / Q000628:therapy*; D035781:Siblings; D014019:Tissue Donors; D016896:Treatment Outcome
D006680:HLA Antigens; D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid