Department of Blood and Marrow Transplantation, Apollo Gleneagles Cancer Hospital, 58 Canal Circular Road, Kolkata, 700054, India.
Int J Hematol. 2013 Oct;98(4):504-8. doi: 10.1007/s12185-013-1426-5. Epub 2013 Sep 6.
We describe a case of severe GVHD in a 3-year-old child who had received a maternal haploidentical allograft for thalassemia major, which was refractory to several lines of therapy, including weekly infusion of mesenchymal cells. The child was infused paternal marrow graft from which T cells were depleted using Campath 'in the bag' without conditioning. There was significant improvement in gut and liver GVHD over the next few weeks along with persistent mixed biparental chimerism before the child succumbed to CMV pneumonitis. This approach hints at the possibility of using parental TCD marrow to salvage GVHD caused by a graft from the other parent, and raises the possibility of biparental grafting along the same lines as double cord transplantation.
我们描述了一例严重的移植物抗宿主病（GVHD）患儿，该患儿因重型地中海贫血接受了母亲半相合同种异体移植，该患儿对包括每周输注间充质细胞在内的多种治疗方案均无效。患儿输注了经 Campath 预处理的、去除 T 细胞的父系骨髓，随后数周内，患儿的肠道和肝脏 GVHD 显著改善，且持续存在混合双亲嵌合体，直到患儿死于 CMV 肺炎。这种方法提示了使用父母 TCD 骨髓来挽救由另一方父母供体引起的 GVHD 的可能性，并提出了沿着与双脐带移植相同的思路进行双亲供体移植的可能性。
