Successful non-T-cell-depleted HLA-haploidentical 3-loci mismatched bone marrow transplantation

Eur J Haematol. 2005 Jun;74(6):529-32. doi: 10.1111/j.1600-0609.2005.00430.x.

Abstract

A 17-year-old boy with therapy-related acute myelocytic leukemia (FAB classification-M0) successfully received allogeneic non-T-cell depleted (non-TCD) bone marrow transplantation (BMT) from his 3-loci HLA-mismatch mother, although pre-BMT detection of feto-maternal microchimerism was negative. The BMT was performed with reduced intensity conditioning (total body irradiation; 4 Gy, fludarabine; 20 mg/m(2) x 6, and melphalan; 70 mg/m(2) x 2) and short-course methotrexate and tacrolimus for GVHD prophylaxis. Complete donor chimera was obtained on day 19, associated with Grade 3 acute GVHD (skin: Stage 1, liver: Stage 0, gut: Stage 3) that was well controlled with immunosuppressive therapies. At day 200 of transplantation, he was in complete remission with no signs of chronic GVHD. Our case suggests that non-TCD HLA-haploidentical 3-loci mismatched BMT can be safely performed from mother to offspring even when feto-maternal microchimerism is barely detectable with the current detection procedure.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Bone Marrow Transplantation*
  • Female
  • Graft vs Host Disease / pathology
  • Graft vs Host Disease / prevention & control
  • HLA Antigens*
  • Histocompatibility Testing
  • Humans
  • Leukemia, Myeloid, Acute / therapy*
  • Male
  • Maternal-Fetal Relations
  • Mothers
  • Remission Induction
  • Tissue Donors
  • Transplantation Chimera
  • Transplantation Conditioning

Substances

  • HLA Antigens