Gennery Andrew R, Slatter Mary A, Bredius Robbert G, Hagleitner Melanie M, Weemaes Corry, Cant Andrew J, Lankester Arjan C
Paediatric Immunology Department, Newcastle General Hospital, Westgate Road, Newcastle Upon Tyne NE4 6BE, United Kingdom.
Pediatrics. 2007 Nov;120(5):e1341-4. doi: 10.1542/peds.2007-0640. Epub 2007 Oct 1.
Immunodeficiency-centromeric instability-facial dysmorphism syndrome, characterized by variable immunodeficiency, centromeric instability, and facial anomalies caused by epigenetic dysregulation resulting in hypomethylation, is caused in many patients by mutations in DNMT3B, a DNA methyltransferase gene; associated infections are a major cause of serious sequelae and death. Hematopoietic stem cell transplantation may improve the clinical course in immunodeficiency-centromeric instability-facial dysmorphism syndrome. We report 3 unrelated patients with persistent infections and intestinal complications who successfully underwent hematopoietic stem cell transplantation after nonmyeloablative or myeloablative conditioning regimens using HLA-matched donors. In all cases, donor chimerism led to resolution of intestinal complications and infections, growth improvement, and correction of the immunodeficiency.
免疫缺陷-着丝粒不稳定-面部畸形综合征的特征是免疫缺陷程度各异、着丝粒不稳定以及由表观遗传失调导致的低甲基化引起的面部异常,许多患者是由DNA甲基转移酶基因DNMT3B的突变所致;相关感染是严重后遗症和死亡的主要原因。造血干细胞移植可能会改善免疫缺陷-着丝粒不稳定-面部畸形综合征的临床病程。我们报告了3例无关患者,他们有持续性感染和肠道并发症,在使用HLA匹配供体进行非清髓性或清髓性预处理方案后成功接受了造血干细胞移植。在所有病例中,供体嵌合现象导致肠道并发症和感染得到缓解、生长改善以及免疫缺陷得到纠正。