Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Case Report
  • Published:

Successful haematopoietic stem cell transplantation from a matched unrelated donor following three graft failures from HLA-mismatched related donors

Summary:

Graft rejection and graft failure are serious complications after allogeneic stem cell transplantation (SCT). We report a patient with CML in first chronic phase who finally engrafted with a transplant from an HLA-identical unrelated donor after graft failures from two related HLA-mismatched sibling donors. After failure of one BM and two PBSC grafts from two 1 HLA-antigen mismatched related donors, the patient was finally successfully transplanted from a subsequently identified HLA-identical unrelated donor (donor 3). At 5 years post transplant, the patient is in complete cytogenetic and molecular remission.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2

Similar content being viewed by others

References

  1. Storb R, Prentice RL, Thomas ED et al. Factors associated with graft rejection after HLA-identical marrow transplantation for aplastic anaemia. Br J Haematol 1983; 55: 573–585.

    Article  CAS  PubMed  Google Scholar 

  2. Uharek L, Glass B, Gaska T et al. Influence of donor lymphocytes on the incidence of primary graft failure after allogeneic bone marrow transplantation in a murine model. Br J Haematol 1994; 88: 79–87.

    Article  CAS  PubMed  Google Scholar 

  3. Beatty PG, Clift RA, Mickelson EM et al. Marrow transplantation from related donors other than HLA-identical siblings. N Engl J Med 1985; 313: 765–771.

    Article  CAS  PubMed  Google Scholar 

  4. Anasetti C, Amos D, Beatty PG et al. Effect of HLA compatibility on engraftment of bone marrow transplants in patients with leukemia or lymphoma. N Engl J Med 1989; 320: 197–204.

    Article  CAS  PubMed  Google Scholar 

  5. Hansen JA, Petersdorf E, Martin PJ, Anasetti C . Hematopoietic stem cell transplants from unrelated donors. Immunol Rev 1997; 157: 141–151.

    Article  CAS  PubMed  Google Scholar 

  6. Kernan NA, Bordignon C, Heller G et al. Graft failure after T-cell-depleted human leukocyte antigen identical marrow transplants for leukemia: I. Analysis of risk factors and results of secondary transplants. Blood 1989; 74: 2227–2236.

    CAS  PubMed  Google Scholar 

  7. Bozdech MJ, Sondel PM, Trigg ME et al. Transplantation of HLA-haploidentical T-cell-depleted marrow for leukemia: addition of cytosine arabinoside to the pretransplant conditioning prevents rejection. Exp Hematol 1985; 13: 1201–1210.

    CAS  PubMed  Google Scholar 

  8. Einsele H, Hebart H, Roller G et al. Detection and identification of fungal pathogens in blood by using molecular probes. J Clin Microbiol 1997; 35: 1353–1360.

    CAS  PubMed  PubMed Central  Google Scholar 

  9. Bader P, Stoll K, Huber S et al. Characterization of lineage-specific chimaerism in patients with acute leukaemia and myelodysplastic syndrome after allogeneic stem cell transplantation before and after relapse. Br J Haematol 2000; 108: 761–768.

    Article  CAS  PubMed  Google Scholar 

  10. Einsele H, Ehninger G, Hebart H et al. Polymerase chain reaction monitoring reduces the incidence of cytomegalovirus disease and the duration and side effects of antiviral therapy after bone marrow transplantation. Blood 1995; 86: 2815–2820.

    CAS  PubMed  Google Scholar 

  11. Ash RC, Horowitz MM, Gale RP et al. Bone marrow transplantation from related donors other than HLA-identical siblings: effect of T cell depletion. Bone Marrow Transplant 1991; 7: 443–452.

    CAS  PubMed  Google Scholar 

  12. Aversa F, Tabilio A, Terenzi A et al. Successful engraftment of T-cell-depleted haploidentical ‘three-loci’ incompatible transplants in leukemia patients by addition of recombinant human granulocyte colony-stimulating factor-mobilized peripheral blood progenitor cells to bone marrow inoculum. Blood 1994; 84: 3948–3955.

    CAS  PubMed  Google Scholar 

  13. McCann SR, Bacigalupo A, Gluckman E et al. Graft rejection and second bone marrow transplants for acquired aplastic anaemia: a report from the Aplastic Anaemia Working Party of the European Bone Marrow Transplant Group. Bone Marrow Transplant 1994; 13: 233–237.

    CAS  PubMed  Google Scholar 

  14. Storb R, Weiden PL, Sullivan KM et al. Second marrow transplants in patients with aplastic anemia rejecting the first graft: use of a conditioning regimen including cyclophosphamide and antithymocyte globulin. Blood 1987; 70: 116–121.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to H Einsele.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Wiesmann, A., Bader, P., Faul, C. et al. Successful haematopoietic stem cell transplantation from a matched unrelated donor following three graft failures from HLA-mismatched related donors. Bone Marrow Transplant 32, 729–731 (2003). https://doi.org/10.1038/sj.bmt.1704191

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.bmt.1704191

Keywords

Search

Quick links