[Chronic graft-versus-host disease with multiple serositis after bone marrow transplantation from non-inherited maternal antigen-complementary sibling donor].

Abstract

We report a patient who developed multiple serositis during chronic graft-versus-host disease (GVHD) after allogeneic bone marrow transplantation from a non-inherited maternal antigen (NIMA) -complementary sibling donor. The patient was a 9-year-old boy with myelodysplastic syndrome, who urgently underwent bone marrow transplantation from his NIMA-complementary HLA two-locus-mismatched sister following graft failure of cord blood transplantation. Engraftment was successfully confirmed and no acute GVHD developed. After withdrawal of tacrolimus to prevent recurrent viral infection, he developed pleural effusion, ascites and edema approximately 6 months after transplantation. His clinical symptoms were resolved by methylprednisolone pulse therapy, but he subsequently progressed to develop pericardial effusion, pneumothorax and truncal panniculitis. Pleural and pericardial effusion contained numerous lymphocytes, which gradually subsided with continuous drainage. His symptoms were thereafter controlled by the addition of mycophenolate mofetil (MMF) administration, and his current performance status is almost perfect by the administration of prednisolone (5 mg/day) and MMF at 6 years after transplantation. Although multiple serositis associated with GVHD is known to have a poor prognosis, the multiple symptoms of this patient improved gradually, probably owing to a lack of acute GVHD and the effect of MMF.

• Authors: Koshi Akahane, Takeshi Inukai, Atsushi Nemoto, Itaru Kuroda, Amane Minai, Kinuko Hirose, Hiroko Honna, Kumiko Goi, Kanji Sugita
• Journal: [Rinsho ketsueki] The Japanese journal of clinical hematology (Rinsho Ketsueki) Vol. 51 Issue 2 Pg. 132-7 (Feb 2010) ISSN: 0485-1439 [Print] Japan
• PMID: 20379105 (Publication Type: Case Reports, Journal Article)

Chemical References

• HLA Antigens
• Immunosuppressive Agents
• Mycophenolic Acid

Topics

• Adolescent
• Bone Marrow Transplantation
• Child
• Chronic Disease
• Drainage
• Female
• Graft vs Host Disease (etiology, therapy)
• HLA Antigens
• Histocompatibility
• Humans
• Immunosuppressive Agents (administration & dosage)
• Male
• Mycophenolic Acid (administration & dosage, analogs & derivatives)
• Myelodysplastic Syndromes (therapy)
• Serositis (etiology, therapy)
• Siblings
• Tissue Donors
• Treatment Outcome