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Successful non-T-cell-depleted nonmyeloablative hematopoietic stem cell transplantation (NST) from an HLA-haploidentical 2-loci-mismatched sibling in a heavily transfused patient with severe aplastic anemia based on the fetomaternal microchimerism

Bone Marrow Transplantation volume 34, pages 267–269 (2004)Cite this article

Summary:

A 37-year-old Japanese man with systemic hemochromatosis due to multiple transfusions was referred to us for the treatment of severe aplastic anemia (SAA), from which he had been suffering for 24 years. The patient had diabetes arising from the hemochromatosis, chronic anal fissures, and a kidney abscess due to neutropenia. He was treated with a nonmyeloablative preconditioning regimen followed by non-T-cell-depleted (non-TCD) allogeneic peripheral blood stem cell transplantation (PBSCT) from his human leukocyte antigen (HLA)-haploidentical 2-loci-mismatched sibling. Prompt engraftment of granulocytes and platelets was observed, and graft-versus-host disease was easy to control. Noninherited maternal antigens in the donor were confirmed prior to PBSCT, and they were also detected in small quantities in the recipient. This report describes the first successful nonmyeloablative hematopoietic stem cell transplant in a heavily transfused SAA patient from an HLA-haploidentical 2-loci-mismatched sibling donor. The result suggests that a long-term fetomaternal microchimerism-positive sibling can be a second-line donor if an alternative HLA-identical donor is not available.

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Authors and Affiliations

  1. Department of Internal Medicine, Hakodate Municipal Hospital, Hakodate, Japan

    Y Tsutsumi, T Miura, S Saitoh, M Yamada, H Yamato, N Ehira, H Kanamori, T Kawamura, S Obara, T Matsushima & N Masauzi

  2. Departments of Hematology and Oncology, Hokkaido University Graduate School of Medicine, Sapporo, Japan

    J Tanaka & M Imamura

  3. Department of General Medicine II, Hakkaido University Graduate School of Medicine, Sapporo, Japan

    N Ogura & H Saji

  4. NPO HLA Laboratory, Hakodate Municipal Hospital, Hakodate, Japan

    E Maruya

  5. Department of Gastroenterology, Hokkaido University Graduate School of Medicine, Sapporo, Japan

    M Asaka

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  1. Y Tsutsumi
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Correspondence to Y Tsutsumi.

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Tsutsumi, Y., Tanaka, J., Miura, T. et al. Successful non-T-cell-depleted nonmyeloablative hematopoietic stem cell transplantation (NST) from an HLA-haploidentical 2-loci-mismatched sibling in a heavily transfused patient with severe aplastic anemia based on the fetomaternal microchimerism. Bone Marrow Transplant 34, 267–269 (2004). https://doi.org/10.1038/sj.bmt.1704567

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