[Bone marrow transplantation for beta-thalassemia major].

To examine the feasibility of bone marrow hematopoietic stem cell transplantation for thalassemia major.
Bone marrow transplantation was performed on a 4-year-old patient with beta-thalassemia major, whose gene mutation was CD41-42/654. The donor was his brother. In the 850ml bone marrow, the nucleated cells were 5.6x10(8)/kg, CD(+)(34) cells 7.8 x 10(6)/kg, and colony-forming-unit-granulocyte-macrophages(CFU-GM) 5.7x10(5)/kg. HLA was one site mismatched, while RBC type matched. Pre-transplant conditions included Busulfan 16mg/kg, cyclophosphamide 200mg/kg and lymphoglobuline 88mg/kg. Cyclosporine and methotrexate were used for prevention of graft-versus-host disease(GVHD).
After transplantation, the patient had grade II acute GVHD and cytomegalovirus(CMV) interstitial pneumonia; he was cured. White blood cells(WBC) and neutrophil granulocytes recovered to 1.1 x 10(9)/L and 0.4 x10(9)/L respectively on day 14 post transplantation. WBC was 4.5 x 10(9)/L on day 18, and descended for a time during treating interstitial pneumonia with Ganciclovir. Platelet(Plt) exceeded 50 x 10(9)/L on day 86 and recovered to normal 5 mothers and a half post transplantation. Hb reached 106g/L on day 128. The patient received the last blood transfusion on day 103. Before transplantation, the patient had to receive 200ml blood infusion per month for maintaining Hb 60-90g/L; after transplantation, his Hb kept up >110g/L for 6 months without blood transfusion. The gene type had changed to donor's CD41-42/N heterozygen.
This is the first report on successful transplantation of bone marrow stem cell for thalassemia major in China, suggesting a new way to treat the disease and to expand the use of BMT. For treatment of CMV interstitial pneumonia post-transplantation, Ganciclovir should be dose enough and be used for at least 2 months.
AuthorsW Zhu, M Yang, X Xing, Y He, X Zhuang, G Guan, X Qian, S Chen
JournalZhonghua yi xue yi chuan xue za zhi = Zhonghua yixue yichuanxue zazhi = Chinese journal of medical genetics (Zhonghua Yi Xue Yi Chuan Xue Za Zhi) Vol. 17 Issue 2 Pg. 79-81 (Apr 2000) ISSN: 1003-9406 [Print] CHINA
PMID10751525 (Publication Type: Case Reports, English Abstract, Journal Article)
Chemical References
  • Ganciclovir
  • Child, Preschool
  • Cytomegalovirus Infections (drug therapy)
  • Ganciclovir (therapeutic use)
  • Hematopoiesis
  • Hematopoietic Stem Cell Transplantation (adverse effects)
  • Humans
  • Male
  • beta-Thalassemia (therapy)

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