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Nonlethal transfusion associated graft-versus-host disease in a severe combined immunodeficient patient

Bone Marrow Transplantation volume 32, pages 1027–1030 (2003)Cite this article

Summary:

An X-linked severe combined immunodeficient (SCID) patient received a nonirradiated erythrocyte transfusion and developed transfusion-associated graft-versus-host disease (TAGVHD), which was controllable with high-dose corticosteroids. Haplo-identical SCT was performed, after a myeloablative conditioning regimen. At day +26, he developed GVHD. Chimerism studies revealed DNA of the erythrocyte transfusion donor (ETD) and recipient only. Because of early nonengraftment and the presence of alloreactive T cells of ETD origin, the patient was treated with an immunosuppressive conditioning regimen followed by a second SCT from the same donor. While tapering immunosuppression, he again developed mild GVHD, and DNA of ETD and bone marrow donor origin were both present. On cyclosporin, the ETD-DNA signal finally disappeared. High-resolution HLA typing revealed haplo-identity between BMD, ETD and the patient, which might have contributed to the relative mild course of the TAGVHD.

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Acknowledgements

The authors would like to thank Joyce van Loon, Petra van der Weide and Anette van Dijk for their excellent technical assistance.

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Authors and Affiliations

  1. Department of Pediatric Immunology, University Medical Center, Utrecht, The Netherlands

    A van Royen-Kerkhof, N M Wulffraat & S S M Kamphuis

  2. Laboratory for Pediatric Immunology, University Medical Center, Utrecht, The Netherlands

    R A Brooimans & G T Rijkers

  3. Department of Pathology, University Medical Center, Utrecht, The Netherlands

    R A de Weger & M G J Tilanus

  4. Sanquin Blood Bank Midden-Nederland, Utrecht, The Netherlands

    E F van Leeuwen

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  1. A van Royen-Kerkhof
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  2. N M Wulffraat
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  4. R A Brooimans
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  5. R A de Weger
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  6. M G J Tilanus
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  7. E F van Leeuwen
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  8. G T Rijkers
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Correspondence to A van Royen-Kerkhof.

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van Royen-Kerkhof, A., Wulffraat, N., Kamphuis, S. et al. Nonlethal transfusion associated graft-versus-host disease in a severe combined immunodeficient patient. Bone Marrow Transplant 32, 1027–1030 (2003). https://doi.org/10.1038/sj.bmt.1704266

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  • DOI: https://doi.org/10.1038/sj.bmt.1704266

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