Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

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.

This is a preview of subscription content, access via your institution

Relevant articles

Open Access articles citing this article.

Access options

Rent or buy this article

Prices vary by article type

from$1.95

to$39.95

Learn more

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2

References

  1. Wagner JL, Deeg HJ, Seidel K et al. Bone marrow transplantation for severe aplastic anemia from genotypically HLA-nonidentical relatives: an update of the Seattle experience. Transplantation 1996; 61: 54–61.

    Article  CAS  Google Scholar 

  2. Bacigalupo A, Schrezenmeier H, Hows J et al. Treatment of acquired severe aplastic anemia for the EBMT Working Party on SAA. Int J Pediatr Hematol Oncol 1997; 4: 267–274.

    Google Scholar 

  3. Deeg HJ, Seidel K, Casper J et al. Marrow transplantation from unrelated donors for patients with severe aplastic anemia who have failed immunosuppressive therapy. Biol Blood Marrow Transplant 1999; 5: 243–252.

    Article  CAS  Google Scholar 

  4. Bacigalupo A, Bland R, Oneto R et al. Treatment of acquired severe aplastic anemia: bone marrow transplantation compared with immunosuppressive therapy – the European Group for Blood and Marrow Transplantation experience. Semin Hematol 2000; 37: 69–80.

    Article  CAS  Google Scholar 

  5. Ichinohe T, Maruya E, Saji H . Long-term feto-maternal microchimerism: nature's hidden clue for alternative donor hematopoietic cell transplantation? Int J Hematol 2002; 76: 229–237.

    Article  Google Scholar 

  6. van Rood JJ, Loberiza FR, Zang MJ et al. Effect of tolerance to noninherited maternal antigens on the occurrence of graft-versus-host disease after bone marrrow transplantation from a parent or an HLA-haploidentical sibling. Blood 2002; 99: 1572–1577.

    Article  Google Scholar 

  7. Tamaki S, Ichinohe T, Matsuo K et al. Superior survival of blood and marrow stem cell recipients given maternal grafts over recipients given paternal grafts. Bone Marrow Transplant 2001; 28: 375–380.

    Article  CAS  Google Scholar 

  8. Shimazaki C, Ochiai N, Uchida R et al. Non-T-cell depleted HLA haploidentical stem cell transplantation in advanced hematologic malignancies based on the feto-maternal microchimerism. Blood 2003; 101: 3334–3336.

    Article  CAS  Google Scholar 

  9. Tzeng CH, Hsieh RK, Fan S et al. Bone marrow transplantation for severe aplastic anemia – a study of twenty-one Chinese patients in Taiwan. Transplantation 1992; 53: 569–574.

    Article  CAS  Google Scholar 

  10. Sondel PM, Bozdech MJ, Trigg ME et al. Additional immunosuppression allows engraftment following HLA-mismatched T-cell-depleted bone marrow transplantation for leukemia. Trans Proc 1985; XVII: 462–464.

    Google Scholar 

  11. Ochiai N, Shimazaki C, Fuchida S et al. Successful non-T cell-depleted HLA haplo-identical three loci mismatched hematopoietic stem cell transplantation from mother to son based on the feto-maternal microchimerism in chronic myelogenous leukemia. Bone Marrow Transplant 2002; 30: 793–796.

    Article  CAS  Google Scholar 

  12. Uoshima N, Kamitsuji Y, Maruya E, Saji H . Successful reduced-intensity stem cell transplantation from an HLA haploidentical 3-loci-mismatched donor on the basis of feto-maternal microchimerism in a patient with advanced acute myeloid leukemia. Int J Hematol 2003; 78: 69–72.

    Article  Google Scholar 

Download references

Author information

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

Authors
  1. Y Tsutsumi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J Tanaka
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. T Miura
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. S Saitoh
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. M Yamada
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. H Yamato
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. N Ehira
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. H Kanamori
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. T Kawamura
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. S Obara
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. N Ogura
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. T Matsushima
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. E Maruya
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. M Asaka
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. M Imamura
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. H Saji
    View author publications

    You can also search for this author in PubMed Google Scholar

  17. N Masauzi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Y Tsutsumi.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

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

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.bmt.1704567

Keywords

  • nonmyeloablative stem cell transplantation (NST)
  • HLA 2-loci-mismatched donor
  • noninherited maternal antigen (NIMA)
  • fetomaternal microchimerism
  • severe aplastic anemia (SAA)

This article is cited by

Search

Advanced search

Quick links