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Nonlethal transfusion associated graft-versus-host disease in a severe combined immunodeficient patient.
- Source :
-
Bone marrow transplantation [Bone Marrow Transplant] 2003 Nov; Vol. 32 (10), pp. 1027-30. - Publication Year :
- 2003
-
Abstract
- An X-linked severe combined immunodeficient (SCID) patient received a nonirradiated erythrocyte transfusion and developed transfusion-associated graft-versus-host disease (TAGVHD), which was controllable with high-dose corticosteroids. Haplo-identical SCT was performed, after a myeloablative conditioning regimen. At day +26, he developed GVHD. Chimerism studies revealed DNA of the erythrocyte transfusion donor (ETD) and recipient only. Because of early nonengraftment and the presence of alloreactive T cells of ETD origin, the patient was treated with an immunosuppressive conditioning regimen followed by a second SCT from the same donor. While tapering immunosuppression, he again developed mild GVHD, and DNA of ETD and bone marrow donor origin were both present. On cyclosporin, the ETD-DNA signal finally disappeared. High-resolution HLA typing revealed haplo-identity between BMD, ETD and the patient, which might have contributed to the relative mild course of the TAGVHD.
- Subjects :
- Adrenal Cortex Hormones therapeutic use
Graft vs Host Disease drug therapy
Hematopoietic Stem Cell Transplantation
Humans
Infant
Male
Severe Combined Immunodeficiency complications
Transplantation Chimera genetics
Treatment Outcome
Erythrocyte Transfusion adverse effects
Graft vs Host Disease etiology
Severe Combined Immunodeficiency therapy
Subjects
Details
- Language :
- English
- ISSN :
- 0268-3369
- Volume :
- 32
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Bone marrow transplantation
- Publication Type :
- Academic Journal
- Accession number :
- 14595391
- Full Text :
- https://doi.org/10.1038/sj.bmt.1704266