Successful Nonmyeloablative Allogeneic Stem Cell Transplant in a Child With Emberger Syndrome and GATA2 Mutation

J Pediatr Hematol Oncol. 2018 Aug;40(6):e383-e388. doi: 10.1097/MPH.0000000000000995.

Abstract

Emberger syndrome with underlying guanine-adenine-thymine-adenine 2 (GATA2) mutation is a rare disorder and very few successful nonmyeloablative allogeneic hematopoietic stem cell transplants (HSCTs) have been reported. We report a case of Emberger syndrome with GATA2 mutation in a 9-year-old girl who presented with congenital sensorineural deafness, warts, lymphedema, and Myelodysplastic syndrome. Her sister had died of a similar illness. She underwent a nonmyeloablative matched related donor peripheral blood HSCT with rabbit antithymoglobulin (5 mg/kg), fludarabine (160 mg/m), cyclophophamide (29 mg/kg), and total body irradiation (2 Gray). Graft versus host disease prophylaxis consisted of tacrolimus and mycophenolate moefetil. She had neutrophil engraftment on day+15 and fully donor chimerism by day+30. She developed limited chronic skin graft versus host disease on tapering off immunosuppression. She is disease free on day+475. The review of literature showed a total of 28 patients with GATA2 mutation have undergone HSCT mostly nonmyeloablative and overall survival is 75%. Nonmyeloablatove HSCT is feasible and safe for the patients with GATA2 mutation.

Publication types

  • Case Reports

MeSH terms

  • Allografts
  • Antilymphocyte Serum / administration & dosage
  • Child
  • Cyclophosphamide / administration & dosage
  • Female
  • GATA2 Deficiency / genetics
  • GATA2 Deficiency / pathology
  • GATA2 Deficiency / therapy*
  • GATA2 Transcription Factor / genetics*
  • Graft vs Host Disease / genetics
  • Graft vs Host Disease / prevention & control
  • Humans
  • Mutation*
  • Mycophenolic Acid / administration & dosage
  • Peripheral Blood Stem Cell Transplantation*
  • Skin Diseases / genetics
  • Skin Diseases / prevention & control
  • Tacrolimus / administration & dosage
  • Transplantation Conditioning*
  • Vidarabine / administration & dosage
  • Vidarabine / analogs & derivatives
  • Whole-Body Irradiation

Substances

  • Antilymphocyte Serum
  • GATA2 Transcription Factor
  • GATA2 protein, human
  • Cyclophosphamide
  • Vidarabine
  • Mycophenolic Acid
  • fludarabine
  • Tacrolimus