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Five donors–one recipient: modeling a mosaic of granulocytes, natural killer and T cells from cord-blood and third-party donors

Nature Clinical Practice Oncology volume 5, pages 291–295 (2008)Cite this article

Abstract

Background A 21-year-old man was admitted to hospital because of leukocytosis, thrombocytopenia and anemia. The patient had been in good health until a few days earlier, when he developed fever and night sweats and his performance status dramatically declined.

Investigations Laboratory tests, immunophenotyping, cytogenetic analyses, bone-marrow biopsy, minimal residual disease analysis using quantitative real-time polymerase chain reaction, differential chimerism analysis using flow cytometry, mixed chimerism analysis, CT scans, electro-encephalography, cerebral magnetic resonance tomography.

Diagnosis Bcr–abl-positive and Philadelphia-chromosome-positive acute lymphoblastic leukemia, and primary graft failure complicated by invasive fungal infection and cytomegalovirus encephalitis.

Management Double cord-blood rescue transplantation, third-party CD34-positive stem-cell rescue transplantation, third-party cytomegalovirus-specific T lymphocyte transplantation.

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Figure 1: Hematological parameters and course of infectious complications during treatment.

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Acknowledgements

The treatment protocol was set up by GS, HE and RH. Single-cell chimerism by flow cytometry and isolation of CMV-reactive T cells was performed by MS, TF and RH. HLA typing was performed by EK. The manuscript was written by BS and GS and critically reviewed by all authors. We are obliged to D Wernet at the University of Tübingen for selecting the third-party donor for the transfer of virus-specific T cells. We thank G Kögler from the cord-blood bank Düsseldorf/José Carreras Foundation for selecting the cord-blood units and for critically reviewing the manuscript. We would also like to thank A Schnack at the University of Würzburg for providing the CT scans, and V Kunzmann at the University of Würzburg for performing the CD34+ cell selection. OG Ottmann performed the MRD monitoring and contributed his experience and information from unpublished data concerning the tyrosine-kinase inhibitor imatinib in bcr–abl-positive ALL. We also thank V Rocha, Paris, for helpful discussions and key treatment suggestions.

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Authors and Affiliations

  1. B Schöttker is a Hematologist/Oncologist and Medical Fellow at the Department of Internal Medicine II, H Einsele is the Director of the Department of Internal Medicine II, and G Stuhler is an Attending Physician at the Department of Internal Medicine II, T Feuchtinger is a Medical Fellow at the Department of Hematology/Oncology and General Pediatrics, and R Handgretinger is the Director of the Department of Hematology/Oncology and General Pediatrics, E Klinker is an Assistant Medical Director at the Institute of Transfusion Medicine and Immunohematology, all at the University of Würzburg, M Schumm is Head of Production at the GMP facility, all at the Children's University Hospital Tübingen, Germany.,

    Björn Schöttker, Tobias Feuchtinger, Michael Schumm, Erdwine Klinker, Rupert Handgretinger, Hermann Einsele & Gernot Stuhler

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  1. Björn Schöttker
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Correspondence to Gernot Stuhler.

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The authors declare no competing financial interests.

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Schöttker, B., Feuchtinger, T., Schumm, M. et al. Five donors–one recipient: modeling a mosaic of granulocytes, natural killer and T cells from cord-blood and third-party donors. Nat Rev Clin Oncol 5, 291–295 (2008). https://doi.org/10.1038/ncponc1105

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