title: Successful Second Allogeneic Stem Cell Transplantation From a Sibling Donor for Relapse of Myelodysplastic Syndrome in a Recipient of a Renal Transplant From His Mother: Case Report.
abstract: There have been few reports on allogeneic stem cell transplantation in patients who have previously undergone solid organ transplantation. The clinical course of such patients is not yet well recognized. Therefore, appropriate immunosuppressive prophylaxis for the rejection of a solid organ graft or for graft-versus-host disease has not yet been established. We present the case of a successful allogeneic stem cell transplantation in a patient who relapsed after a first allogeneic stem cell transplantation for myelodysplastic syndrome and who had previously undergone renal transplantation. The prophylaxis in this case for graft-versus-host disease and rejection of the transplanted kidney was mycophenolate mofetil and tacrolimus. No hyperacute rejection of the transplanted kidney was observed. However, the patient's renal function deteriorated after the cessation of the mycophenolate mofetil and the reduction of the tacrolimus. This deterioration seemed to be due to rejection with humoral immunity of donor lymphocytes, and we were able to control it by resuming the mycophenolate mofetil and local graft irradiation.
authors.affiliation: Division of Hematology, Japanese Red Cross Medical Center, Tokyo, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Ikeda
authors.affiliation: Division of Hematology, Japanese Red Cross Medical Center, Tokyo, Japan. Electronic address: tsukada-imsut@umin.ac.jp.
authors.forename: N
authors.initials: N
authors.lastname: Tsukada
authors.affiliation: Division of Hematology, Japanese Red Cross Medical Center, Tokyo, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Chikai
authors.affiliation: Division of Urology, Department of Regenerative and Transplant Medicine, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Tasaki
authors.affiliation: Division of Urology, Department of Regenerative and Transplant Medicine, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Saito
authors.affiliation: Division of Urology, Department of Regenerative and Transplant Medicine, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Nakagawa
authors.affiliation: Niigata Organ Transplant Foundation, Tokyo, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Takahashi
authors.affiliation: Division of Hematology, Japanese Red Cross Medical Center, Tokyo, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Suzuki
mesh_terms: D004359:Drug Therapy, Combination; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control; D006086:Graft vs Host Disease / Q000517:prevention & control; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation; D015470:Leukemia, Myeloid, Acute / Q000150:complications; D008297:Male; D008875:Middle Aged; D009035:Mothers; D009173:Mycophenolic Acid / Q000627:therapeutic use; D009190:Myelodysplastic Syndromes / Q000628:therapy*; D012008:Recurrence; D019233:Retreatment; D035781:Siblings; D016559:Tacrolimus / Q000627:therapeutic use; D014019:Tissue Donors; D066027:Transplant Recipients; D014184:Transplantation, Homologous
chemical_list: D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid; D016559:Tacrolimus