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Autoimmune-like hepatitis following unrelated BMT successfully treated with rituximab

Bone Marrow Transplantation volume 47, pages 600–602 (2012)Cite this article

We report a case of autoimmune-like hepatitis, as defined by the modified criteria of the International Autoimmune Hepatitis Group,1 that developed in a patient following unrelated BMT and was successfully treated using rituximab.

A 1-year-old girl was diagnosed with AML in August 2007. She achieved CR with multi-drug chemotherapy. However, relapse occurred in the BM in May 2009. Following reinduction chemotherapy, she was transferred to our hospital, where she underwent allogeneic BMT from an HLA 8/8-matched unrelated donor in March 2010 during second CR. The conditioning regimen consisted of BU 1.2 mg/kg/dose × 4 doses a day for 4 days from day −9 to −6, melphalan 90 mg/m2 for 2 days from day −5 to −4 and fludarabine 30 mg/m2 for 4 days from day −5 to −2. On day 0, 4.5 × 108/kg nucleated marrow cells (0.5 × 106/kg CD34+ cells) were infused. Tacrolimus (0.02 mg/kg/day) and short-term MTX (15 mg/m2 on day 1, 10 mg/m2 on days 3, 6 and 11) were employed as prophylaxis against GVHD. Engraftment of neutrophils was achieved on day 14. Complete chimerism of blood cells was confirmed by STR analysis on day 80. Acute GVHD was not observed. Tacrolimus was discontinued on day 85 and the patient was discharged on day 99 without any complications.

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Authors and Affiliations

  1. Department of Pediatrics, Nagoya University Graduate School of Medicine, Aichi, Japan

    A Narita, H Muramatsu, Y Takahashi, H Sakaguchi, S Doisaki, N Nishio, A Hama, A Shimada & S Kojima

  2. Department of Pathology, Japanese Red Cross Nagoya First Hospital, Aichi, Japan

    M Ito

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  1. A Narita
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  2. H Muramatsu
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  3. Y Takahashi
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Correspondence to S Kojima.

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Narita, A., Muramatsu, H., Takahashi, Y. et al. Autoimmune-like hepatitis following unrelated BMT successfully treated with rituximab. Bone Marrow Transplant 47, 600–602 (2012). https://doi.org/10.1038/bmt.2011.124

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