We describe a case of severe GVHD in a 3-year-old child who had received a maternal haploidentical allograft for thalassemia major, which was refractory to several lines of therapy, including weekly infusion of mesenchymal cells. The child was infused paternal marrow graft from which T cells were depleted using Campath 'in the bag' without conditioning. There was significant improvement in gut and liver GVHD over the next few weeks along with persistent mixed biparental chimerism before the child succumbed to CMV pneumonitis. This approach hints at the possibility of using parental TCD marrow to salvage GVHD caused by a graft from the other parent, and raises the possibility of biparental grafting along the same lines as double cord transplantation.

Download full-text PDF

Source
http://dx.doi.org/10.1007/s12185-013-1426-5DOI Listing

Publication Analysis

Top Keywords

severe gvhd
8
maternal haploidentical
8
biparental chimerism
8
paternal bone
4
bone marrow
4
marrow infusion
4
infusion salvage
4
salvage therapy
4
therapy severe
4
gvhd
4

Similar Publications

Introduction: Graft-versus-host disease (GvHD) remains a major complication of allogeneic stem cell transplantation (allo-SCT), affecting 30-70% of patients (representing 800 new patients per year in the UK). The risk is higher in patients undergoing unrelated allo-SCT. About 1 in 10 patients die as a result of GvHD or through complications of its treatment.

View Article and Find Full Text PDF

Donor-specific antibodies (DSAs) are essential causes of graft rejection in haploidentical hematopoietic stem cell transplantation (haplo-HSCT). DSAs are unavoidable for some patients who have no alternative donor. Effective interventions to reduce DSAs are still needed, and the cost of the current therapies is relatively high.

View Article and Find Full Text PDF

Chronic Graft-versus-host disease (GVHD) is a major complication of allogeneic hematopoietic stem cell transplantation (HSCT), affecting the female genital tract in 25-66% of the patients. This condition, referred to as Genital GVHD is an underdiagnosed gynecologic comorbidity, that can significantly impair quality of life. We aimed to describe the prevalence and management of genital GVHD following HSCT.

View Article and Find Full Text PDF

While highly morbid forms of chronic graft versus host disease (cGVHD) and severe late effects of allogeneic hematopoietic cell transplant (HCT) can impact children and adults alike, unique considerations arise in pediatric cases regarding diagnosis, monitoring, treatment, and likelihood of resolution. As children can present with atypical features of cGVHD, and with more significant disease due to inability to communicate symptoms, they may be at increased risk for highly morbid forms of cGVHD and incur greater subsequent late effects, which may be more pronounced in those with underlying chromosomal breakage syndromes, with higher prevalence in pediatric HCT recipients. The long-term effects of cGVHD and its therapies include impaired immune reconstitution, leading to increased risks of infection and secondary malignant neoplasms.

View Article and Find Full Text PDF

Purpose: This study compared the outcomes of haploidentical-related donor (HRD) and umbilical cord blood (UCB) hematopoietic stem cell transplantation (HSCT) in pediatric patients with hematologic malignancies.

Methods: Data on patients who underwent HRD HSCT with post-transplant cyclophosphamide (n = 41) and UCB HSCT (n = 24) after targeted busulfan-based myeloablative conditioning with intensive pharmacokinetic monitoring between 2009 and 2018 were retrospectively analyzed.

Results: The median follow-up durations in the HRD and UCB groups were 7.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!