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Donor lymphocyte infusions for refractory pure red cell aplasia relapsing after both autologous and nonmyeloablative allogeneic peripheral stem cell transplantation

Bone Marrow Transplantation volume 33, pages 769–771 (2004)Cite this article

Summary:

Pure red cell aplasia (PRCA) is characterized by a selective marrow aplasia of the erythroid compartment. Immunosuppressive therapy achieves good results in about 25% of cases, but relapses are frequent. Autologous or allogeneic haematopoietic stem cell transplantation (HSCT) may be valuable in selected patients. Here, we report details of a 29-year-old woman treated successfully by donor lymphocyte infusions (DLIs) following allogeneic HSCT for acquired refractory relapsed PRCA. The nonmyeloablative conditioning regimen consisted of cyclophosphamide 60 mg/kg/day for 2 days and fludarabine 30 mg/m2 daily for 4 days. Haematopoiesis was still completely ‘recipient’ 1 month after allo-HSCT, but progressed to full donor engraftment after three doses of ‘escalating’ DLI. The possible role of a graft-versus-autoimmunity effect induced by allogeneic HSCT followed by DLI infusions in the treatment of the disease is discussed.

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Acknowledgements

We thank Professor Alberto Marmont for fruitful and stimulating discussion and Dr Silvia Hutchings for linguistic revision of the paper.

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  1. Dipartimento Oncologico, UO Oncoematologia e Trapianto di Midollo, ‘La Maddalena’, Palermo, Italy

    M Musso, F Porretto, A Crescimanno, V Polizzi & R Scalone

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  1. M Musso
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  2. F Porretto
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  3. A Crescimanno
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  4. V Polizzi
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  5. R Scalone
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Correspondence to M Musso.

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Musso, M., Porretto, F., Crescimanno, A. et al. Donor lymphocyte infusions for refractory pure red cell aplasia relapsing after both autologous and nonmyeloablative allogeneic peripheral stem cell transplantation. Bone Marrow Transplant 33, 769–771 (2004). https://doi.org/10.1038/sj.bmt.1704419

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Keywords

  • severe autoimmune diseases
  • graft-versus-autoimmunity
  • allogeneic nonmyeloablative stem cell transplant
  • DLI

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