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Successful T-cell-replete peripheral blood stem cell transplantation from HLA-haploidentical microchimeric mother to daughter with refractory acute lymphoblastic leukemia using reduced-intensity conditioning

Bone Marrow Transplantation volume 31, pages 1061–1063 (2003)Cite this article

Summary:

A 16-year-old girl with refractory acute lymphoblastic leukemia underwent reduced-intensity hematopoietic stem cell transplantation from her two-locus-mismatched haploidentical mother, who was microchimeric for the patient's hematopoietic cells. The conditioning regimen comprised melphalan, fludarabine, and low-dose total body irradiation. Non-T-cell-depleted peripheral blood stem cells were infused with graft-versus-host disease (GVHD) prophylaxis consisting of tacrolimus, prednisolone, and short-course methotrexate. Complete donor-type engraftment without evidence of residual leukemia was confirmed on day 22. Severe GVHD was not observed despite rapid cessation of immunosuppression. The patient remains well in continuous remission 15 months after transplant. This successful experience suggests that maternal hematopoietic stem cell transplants for children, in the presence of microchimerism, may be associated with hyporesponsiveness to the inherited paternal HLA antigens (IPA); preventing severe GVHD.

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Acknowledgements

We thank Dr Yuichi Akiyama (Department of Pediatrics, Kyoto National Hospital) for valuable suggestions regarding our patient.

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Authors and Affiliations

  1. Department of Pediatrics, Graduate School of Medicine, Kyoto University, Japan

    K Umeda, S Adachi, H Ishihara, Y Higashi, M Shiota, K-I Watanabe & T Nakahata

  2. Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Japan

    M Hishizawa, T Ichinohe & T Uchiyama

  3. Department of Pediatrics, Shiga Medical Center for Children, Shiga, Japan

    T Kitoh

  4. HLA Laboratory, Kyoto, Japan

    E Maruya & H Saji

Authors
  1. K Umeda
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  2. S Adachi
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  3. H Ishihara
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  4. Y Higashi
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  5. M Shiota
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  6. K-I Watanabe
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  7. M Hishizawa
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  8. T Ichinohe
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  9. T Kitoh
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  10. E Maruya
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  11. H Saji
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  12. T Uchiyama
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  13. T Nakahata
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Umeda, K., Adachi, S., Ishihara, H. et al. Successful T-cell-replete peripheral blood stem cell transplantation from HLA-haploidentical microchimeric mother to daughter with refractory acute lymphoblastic leukemia using reduced-intensity conditioning. Bone Marrow Transplant 31, 1061–1063 (2003). https://doi.org/10.1038/sj.bmt.1704057

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  • DOI: https://doi.org/10.1038/sj.bmt.1704057

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