Transplantation of CD34-enriched peripheral stem cells from an HLA-haplotype mismatched donor to a patient with severe aplastic anemia

Bone Marrow Transplant. 2001 Jan;27(1):111-3. doi: 10.1038/sj.bmt.1702748.

Abstract

A 14-year-old girl developed very severe aplastic anemia unresponsive to steroids, cyclosporine, ATG and filgrastim. She experienced repeated bacterial infections, hypermenorrhagia and epistaxis and received numerous transfusions. Lacking a matched family or unrelated donor, she was transplanted 6 months after diagnosis with CD34+ cell-enriched peripheral stem cells from her HLA-haploidentical uncle. Conditioning included fludarabine, cyclophosphamide, 800 cGy TLI and OKT3. Prompt and sustained trilineage engraftment occurred. Acute GVHD grade 1 and herpes esophagitis were successfully treated. Eight months after grafting she was well with stable hematopoiesis. She then succumbed to fulminant hepatic failure due to adenovirus infection.

Publication types

  • Case Reports

MeSH terms

  • Adenoviridae Infections / etiology
  • Adolescent
  • Anemia, Aplastic / complications
  • Anemia, Aplastic / therapy*
  • Antigens, CD34 / blood*
  • Female
  • Graft Survival
  • Haplotypes / immunology*
  • Hematopoiesis
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Hematopoietic Stem Cell Transplantation* / methods
  • Histocompatibility Testing / standards
  • Humans
  • Liver Failure / virology
  • Stem Cells / immunology*
  • Transplantation Conditioning

Substances

  • Antigens, CD34