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.

  • Correspondence
  • Published:

Non-T-cell-depleted HLA haploidentical stem cell transplantation based on feto-maternal microchimerism in pediatric patients with advanced malignancies

Bone Marrow Transplantation volume 34, pages 373–375 (2004)Cite this article

The persistence of fetal hematopoietic cells in maternal blood after birth, or feto-maternal microchimerism, has recently been suggested to be an indicator of immunologic hyporesponsiveness between mother and offspring.1, 2 Guided by the hypothesis that persistent maternal microchimerism indicates tolerance to fetally inherited paternal antigens (IPA) in children and that microchimerism among siblings with mismatched maternal antigens results in mutual tolerance to noninherited maternal antigens (NIMA), feto-maternal immunologic tolerance in allogeneic stem cell transplantation (SCT) has recently been investigated.2, 3, 4, 5, 6 Based on this premise, we used non-T-cell-depleted (TCD) stem cells from haploidentical family donors for transplantation. We report here a total of 11 pediatric patients with advanced hematologic malignancies or solid tumors who underwent non-TCD haploidentical SCT.

Patient characteristics are shown in Table 1. All patients lacking HLA-matched family member donors were acutely ill and time was not available to search for unrelated HLA-matched donors. Non-TCD haploidentical SCT was performed as a second allogeneic transplant in these four patients because of early primary rejection after unrelated cord blood transplantation (UCBT) (cases 3, 6 and 10) and chemorefractory relapse after UCBT (case 4). Non-TCD haploidentical SCT was performed after autologous SCT in two solid tumor patients (cases 9 and 11). In the remaining five patients, non-TCD haploidentical SCT was employed as the first transplant. After informed consent and permission were obtained from guardians and from the ethical committee at the transplant hospitals, healthy haploidentical family donors were selected based on feto-maternal microchimerism. Nine of the donors were mothers and two were NIMA-mismatched siblings. HLA incompatibilities that increase susceptibility to graft-versus-host disease (GVHD) were three-loci mismatches in three patients, two-loci mismatches in five patients and one-locus mismatch in three patients, while incompatibilities that increase susceptibility to HVG were three-loci mismatches in two patients, 2-loci mismatches in five patients, one-locus mismatch in two patients and no mismatch in two patients, respectively.

Table 1 Patient characteristics
Full size table

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

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

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

References

  1. Evans PC, Lambert N, Maloney S et al. Long-term fetal microchimerism in peripheral blood mononuclear cell subsets in healthy women and women with scleroderma. Blood 1999; 93: 2033–2037.

    CAS  Google Scholar 

  2. Ichinoche 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 

  3. 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 

  4. 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 2003; 31: 1061–1063.

    Article  CAS  Google Scholar 

  5. Ishida H, Morimoto A, Yoshihara T et al. Non-T-cell-depleted HLA-haploidentical hematopoietic stem cell transplantation from a family donor based on feto-maternal microchimerism in pediatric hematological malignancies. J Pediatr Hematol Oncol 2004; 26: 68–71.

    Article  Google Scholar 

  6. 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 

  7. Tokita K, Terasaki P, Maruya E, Saji H . Tumor regression following stem cell infusion from daughter to microchimeric mother. Lancet 2001; 358: 2047–2048.

    Article  CAS  Google Scholar 

  8. Ochiai N, Inaba T, Maruya E et al. Feto-maternal microchimaerism does not indicate the existence of feto-maternal immunological tolerance in human leucocyte antigen haploidentical haematopoietic stem cell transplantation from mother to offspring. Br J Haematol 2003; 122: 869–870.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatrics, Matsushita Memorial Hospital, Osaka, Japan

    T Yoshihara, H Ishida & T Imamura

  2. Department of Pediatrics, Kyoto Prefectural University of Medicine, Kyoto, Japan

    A Morimoto & S Todo

  3. Department of Pediatrics, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan

    T Inukai, K Sugita, K Goi & S Nakazawa

  4. Department of Pediatrics, Kyoto City Hospital, Kyoto, Japan

    H Kuroda

  5. HLA laboratory, Kyoto, Japan

    E Maruya & H Saji

  6. Kyoto City Institute of Health and Environmental Sciences, Kyoto, Japan

    S Imashuku

Authors
  1. T Yoshihara
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A Morimoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. T Inukai
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. H Kuroda
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. H Ishida
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. K Sugita
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. K Goi
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. T Imamura
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. S Todo
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. E Maruya
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. H Saji
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. S Nakazawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. S Imashuku
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Yoshihara, T., Morimoto, A., Inukai, T. et al. Non-T-cell-depleted HLA haploidentical stem cell transplantation based on feto-maternal microchimerism in pediatric patients with advanced malignancies. Bone Marrow Transplant 34, 373–375 (2004). https://doi.org/10.1038/sj.bmt.1704597

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.bmt.1704597

This article is cited by

Search

Advanced search

Quick links