Treatment of donor T cell-mediated hematopoietic suppression after haploidentical bone marrow transplantation by T cell modulation in a patient with severe combined immunodeficiency

Bone Marrow Transplant. 1992 Jan;9(1):57-62.

Abstract

An 8-month-old male patient with severe combined immunodeficiency syndrome was transplanted with maternal, haploidentical T cell-depleted bone marrow without prior conditioning therapy. Acute graft-versus-host disease developed 2 weeks post bone marrow transplantation (BMT) and was successfully treated with cortisone. After cortisone withdrawal the patient developed myeloid and B cell depression concomitant with T cell activation. For specific T cell modulation, treatment with the T cell receptor (TCR) alpha beta chain-binding MoAb BMA031 was initiated in combination with cyclosporin A. GM-CSF was given to enhance myeloid reconstitution. About 1 year post BMT, B cell and granulocyte counts were within the normal range with stable chimerism in both lineages. B cell proliferation tests were normal and first signs of in vitro immunoglobulin synthesis occurred.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Agranulocytosis / etiology
  • Agranulocytosis / therapy
  • Antibodies, Monoclonal / therapeutic use
  • B-Lymphocytes / immunology
  • Bone Marrow Transplantation / adverse effects*
  • Bone Marrow Transplantation / immunology
  • Graft vs Host Disease / etiology
  • Graft vs Host Disease / therapy
  • Granulocyte-Macrophage Colony-Stimulating Factor / therapeutic use
  • Humans
  • Infant
  • Male
  • Receptors, Antigen, T-Cell, alpha-beta
  • Severe Combined Immunodeficiency / immunology
  • Severe Combined Immunodeficiency / surgery*
  • Severe Combined Immunodeficiency / therapy
  • T-Lymphocytes / immunology*

Substances

  • Antibodies, Monoclonal
  • Receptors, Antigen, T-Cell, alpha-beta
  • Granulocyte-Macrophage Colony-Stimulating Factor