Successful unmanipulated peripheral blood progenitor cell transplantation from an HLA haploidentical 2-locus-mismatched mother in a thalassemic patient with primary graft failure after transplantation of bone marrow and cord blood from unrelated donors

Pediatr Transplant. 2008 Mar;12(2):232-4. doi: 10.1111/j.1399-3046.2007.00844.x.

Abstract

We report on a boy with beta-thalassemia major who developed early graft failure after double-unit unrelated cord blood transplantation, who subsequently received a myeloablative preconditioning regimen using non-T-cell-depleted PBSCT from his HLA-haploidentical 2-loci-mismatched mother. Neutrophil recovery with full donor chimerism was observed at post-transplantation day +11. Furthermore, GVHD was easy to control. The patient was transfusion-independent with complete donor chimerism eight months post-transplant. The result indicated that fetomaternal microchimerism may be an important attribute of a successful transplant. We suggested that a third allo-HSCT may be taken into consideration for patients with transfusion-dependent thalassemia who experience graft failure, even after two previous transplants.

Publication types

  • Case Reports

MeSH terms

  • Bone Marrow Transplantation*
  • Child, Preschool
  • Chimerism
  • Cord Blood Stem Cell Transplantation*
  • Graft Survival
  • Graft vs Host Disease / therapy
  • HLA Antigens
  • Humans
  • Male
  • Peripheral Blood Stem Cell Transplantation*
  • Tissue Donors
  • beta-Thalassemia / surgery*

Substances

  • HLA Antigens