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Hematopoietic cell transplantation for mucopolysaccharidosis IIB (Hunter syndrome); an ethical commentary

Abstract

Hunter syndrome is an X-linked metabolic storage disorder arising from deficiency of iduronate sulfatase enzyme activity. Despite the successful use of hematopoietic cell transplantation for a variety of lysosomal and peroxisomal storage diseases, limited benefit occurs following transplantation in either the severe or mild forms of Hunter syndrome. A brief ethical commentary is provided on the case of a boy with mucopolysaccharidosis IIB (ie the mild form) who received an unrelated umbilical cord blood transplant to improve his future quality of life. Bone Marrow Transplantation (2000) 25, 1097–1099.

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References

  1. Lowery RB, Applegarth DA, Toone JR et al. An update on the frequency of mucopolysaccharide syndromes in British Columbia Hum Genet 1990 85: 389–390

    Google Scholar 

  2. Young ID, Harper PS . The natural history of the severe form of Hunter's syndrome: a study based on 52 cases Dev Med Child Neurol 1983 25: 481–489

    Article  CAS  Google Scholar 

  3. Schaap T, Bach G . Incidence of mucopolysaccharidoses in Israel: is Hunter disease a ‘Jewish disease’? Hum Genet 1980 56: 221–223

    Article  CAS  Google Scholar 

  4. Meikle PJ, Hopwood JJ, Clague AE, Carey WF . Prevalence of lysosomal storage disorders JAMA 1999 281: 249–254

    Article  CAS  Google Scholar 

  5. Neufeld EF, Muenzer J . The mucopolysaccharidoses. In: Scriver CR, Beaudet AL, Sly WS, Valle D (eds) The Metabolic and Molecular Bases of Inherited Disease McGraw-Hill: New York 1995 2465–2494

    Google Scholar 

  6. Lee C, Dineen TE, Brack M et al. The mucopolysaccharidoses: characterization by cranial MR imaging Am J Neuroradiol 1993 14: 1285–1292

    CAS  PubMed  Google Scholar 

  7. Parsons VJ, Hughes DG, Wraith JE . Magnetic resonance imaging of the brain, neck and cervical spine in mild Hunter's syndrome (mucopolysaccharidosis type II) Clin Radiol 1996 51: 719–723

    Article  CAS  Google Scholar 

  8. Bax MC, Colville GA . Behaviour in mucopolysaccharide disorders Arch Dis Child 1995 73: 77–81

    Article  CAS  Google Scholar 

  9. Hobbs JR, Hugh-Jones K, Barrett AJ et al. Reversal of clinical features of Hurler's disease and biochemical improvement after treatment by bone marrow transplantation Lancet 1981 2: 709–712

    Article  CAS  Google Scholar 

  10. Peters C, Balthazor M, Shapiro EG et al. Outcome of unrelated donor bone marrow transplantation in 40 children with Hurler syndrome Blood 1996 87: 4894–4902

    CAS  PubMed  Google Scholar 

  11. Peters C, Shapiro EG, Anderson J et al. Hurler syndrome: II. Outcome of HLA-genotypically identical sibling and HLA-haploidentical related donor bone marrow transplantation in fifty-four children Blood 1998 91: 2601–2608

    CAS  PubMed  Google Scholar 

  12. Krivit W, Pierpont M, Ayaz K et al. Bone marrow transplantation in the Maroteaux–Lamy syndrome (mucopoly-saccharidosis type VI) New Engl J Med 1984 311: 1606–1611

    Article  CAS  Google Scholar 

  13. Aubourg P, Blanche S, Jamabaque I et al. Reversal of early neurologic and neuroradiologic manifestations of X-linked adrenoleukodystrophy by bone marrow transplantation New Engl J Med 1990 332: 1860–1866

    Article  Google Scholar 

  14. Krivit W, Shapiro E, Kennedy W et al. Treatment of late infantile metachromatic leukodystrophy by bone marrow transplantation New Engl J Med 1990 322: 28–32

    Article  CAS  Google Scholar 

  15. Krivit W, Shapiro EG, Peters C et al. Hematopoietic stem-cell transplantation in globoid-cell leukodystrophy New Engl J Med 1998 338: 1119–1126

    Article  CAS  Google Scholar 

  16. Mullen CA, Thompson JN, Richard LA, Chan KW . Unrelated umbilical cord blood transplantation in infancy for mucopolysaccharidosis type IIB (Hunter syndrome) complicated by autoimmune hemolytic anemia Bone Marrow Transplant 2000 25: 1093–1097

    Article  CAS  Google Scholar 

  17. McKinnis EJ, Sulzbacher S, Rutledge JC et al. Bone marrow transplantation in Hunter syndrome J Pediatr 1996 129: 145–148

    Article  CAS  Google Scholar 

  18. Coppa GV, Gabrielli O, Zampini L et al. Bone marrow transplantation in Hunter syndrome (mucopolysaccharidosis type II): two-year follow-up of the first Italian patient and review of the literature Pediatria Medica Chirurgica 1995 17: 227–235

    CAS  Google Scholar 

  19. Bergstrom SK, Quinn JJ, Greenstein R, Ascensao J . Long-term follow-up of a patient transplanted for Hunter's disease type IIB: a case report and literature review Bone Marrow Transplant 1994 14: 653–658

    CAS  PubMed  Google Scholar 

  20. Imaizumi M, Gushi K, Kurobane I et al. Long-term effects of bone marrow transplantation for inborn errors of metabolism: a study of four patients with lysosomal storage diseases Acta Paediatrica Japonica 1994 36: 30–36

    Article  CAS  Google Scholar 

  21. Braun SE, Pan D, Aronovich EL et al. Preclinical studies of lymphocyte gene therapy for mild Hunter (mucopoly-saccharidosis type II) Hum Gene Ther 1996 7: 283–290

    Article  CAS  Google Scholar 

  22. Whitley CB, McIvor RS, Aronovich EL et al. Retroviral-mediated transfer of the iduronate-2-sulfatase gene intolymphocytes for treatment of mild Hunter syndrome (mucopolysaccharidosis type II) Hum Gene Ther 1996 7: 537–549

    Article  CAS  Google Scholar 

  23. Weir RF, Peters C . Affirming the decisions adolescents make about life and death Hastings Center Report 1997 27: 29–40

    Article  CAS  Google Scholar 

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Peters, C., Krivit, W. Hematopoietic cell transplantation for mucopolysaccharidosis IIB (Hunter syndrome); an ethical commentary. Bone Marrow Transplant 25, 1097–1099 (2000). https://doi.org/10.1038/sj.bmt.1702398

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