Successful unrelated umbilical cord blood cell transplantation without conditioning for a neonate with severe combined immunodeficiency.
A neonate was diagnosed as having SCID from his umbilical cord blood cells immediately after birth because his older brother had died of SCID eight months earlier. One locus-mismatched unrelated umbilical cord blood cell transplantation without conditioning was performed at the age of 30 days. The CD3-positive cells were detected on day 14 post-transplantation. There were no peri-transplantation complications. Four yr after transplantation, the boy is in excellent condition and T and NK cell engraftments are complete. His peripheral B cells with a common gamma chain were not detected by flow cytometry, and he still needs IgG replacement; however, his IgM and IgA levels have gradually increased, and the dosage of IVIG per body weight has gradually decreased. We speculate that the very few B cells that proliferate from transplanted cord blood cells produce gamma globulin. Unrelated cord blood cell transplantation, even though mismatched, without conditioning would be a treatment option for neonates with severe combined immunodeficiency.
Taga
Takashi
T
Department of Pediatrics, Shiga University of Medical Science, Ohtsu, Japan. ttaga@belle.shiga-med.ac.jp
Itoh
Eisuke
E
Noda
Yasuyo
Y
Kato
Hirofumi
H
Maruo
Yoshihiro
Y
Takano
Tomoyuki
T
Ohta
Shigeru
S
Takeuchi
Yoshihiro
Y
Kumaki
Satoru
S
D001402:B-Lymphocytes / Q000276:immunology; D017252:CD3 Complex / Q000096:biosynthesis; D002675:Child, Preschool; D036101:Cord Blood Stem Cell Transplantation / Q000379:methods*; D005312:Fetal Blood / Q000166:cytology*; D005434:Flow Cytometry / Q000379:methods; D006680:HLA Antigens / Q000737:chemistry; D006801:Humans; D007070:Immunoglobulin A / Q000737:chemistry; D007074:Immunoglobulin G / Q000737:chemistry; D007075:Immunoglobulin M / Q000737:chemistry; D007694:Killer Cells, Natural / Q000166:cytology; D008297:Male; D009154:Mutation; D016511:Severe Combined Immunodeficiency / Q000628:therapy*; D013601:T-Lymphocytes / Q000166:cytology; D019172:Transplantation Conditioning / Q000379:methods; D005719:gamma-Globulins / Q000276:immunology
D017252:CD3 Complex; D006680:HLA Antigens; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D005719:gamma-Globulins