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Bone marrow transplantation in a case of severe, type II congenital dyserythropoietic anaemia (CDA II)

Bone Marrow Transplantation volume 27, pages 213–215 (2001)Cite this article

Abstract

Type II congenital dyserythropoietic anaemia (CDA-II or HEMPAS) is an autosomal recessive disorder, representing the most frequent form of congenital dyserythropoiesis. It is characterised by normocytic anaemia, variable jaundice and hepato-splenomegaly. Gallbladder disease and secondary haemochromatosis are frequent complications. We report a case characterised by severe transfusion-dependent anaemia. The proband inherited CDA-II in association with beta-thalassaemia trait. Splenectomy did not abolish the transfusion dependence and this, in association with poor compliance to iron-chelation therapy, prompted us to consider bone marrow transplantation (BMT) from his HLA-identical sibling. The preparative regimen included busulfan, thiotepa and fludarabine, and graft-versus-host disease prophylaxis consisted of cyclosporin A and short-term methotrexate. Engraftment of donor cells was prompt and the post-transplant course uncomplicated. The patient is alive and transfusion-independent 36 months after allograft. This is the first case of severe CDA-II to undergo BMT. Analysis of this pedigree suggests that interaction with beta-thalassaemia enhanced the clinical severity of CDA-II, making BMT an attractive therapy for patients with transfusion dependence. Bone Marrow Transplantation (2001) 27, 213–215.

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Acknowledgements

This work was partly supported by grants from Associazione Italiana Ricerca sul Cancro (AIRC), Consiglio Nazionale delle Ricerche (CNR) and IRCCS Policlinico San Matteo to FL and by a grant from Telethon (project E-645) to AI.

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  1. Biomedicina dell'Età Evolutiva, Università di Bari, Italy

    A Iolascon, V Sabato & D de Mattia

  2. Dipartimento di Scienze Pediatriche, IRCCS Policlinico San Matteo, Università di Pavia, Italy

    F Locatelli

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  1. A Iolascon
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  2. V Sabato
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  3. D de Mattia
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  4. F Locatelli
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Iolascon, A., Sabato, V., de Mattia, D. et al. Bone marrow transplantation in a case of severe, type II congenital dyserythropoietic anaemia (CDA II). Bone Marrow Transplant 27, 213–215 (2001). https://doi.org/10.1038/sj.bmt.1702764

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