Serial transplantation of mismatched donor hematopoietic cells between HLA-identical sibling pairs with congenital immunodeficiency: in vivo tolerance permits rapid immune reconstitution following T-replete transplantation without GVHD in the secondary recipient.

Abstract

We report serial transplantation procedures in 2 sets of brothers with X-linked primary immunodeficiency. The first boy in each family received a T-cell-depleted transplant from a mismatched donor. The recipients then acted as donors for T-replete transplantation of the "tolerized" graft into their HLA-identical brothers with the same disorder. Immune reconstitution was noted to occur at a significantly faster rate in the secondary recipients, and without the occurrence of graft-versus-host disease (GVHD), despite the presence of donor cells mismatched for 1 to 3 HLA antigens. This serial transplantation technique allows the primary recipient of HLA-mismatched donor cells to act as a functionally "HLA-matched" donor for subsequent affected siblings, and should be considered as a therapeutic option in families with congenital disorders.

• Authors: Jonathan M Cohen, Valerie Rogers, H Bobby Gaspar, Alison Jones, E Graham Davies, Kanchan Rao, Daniel J McCloskey, Kimberley Gilmour, Robert Wynn, Persis J Amrolia, Paul Veys
• Journal: Blood (Blood) Vol. 108 Issue 6 Pg. 2124-6 (Sep 15 2006) ISSN: 0006-4971 [Print] United States
• PMID: 16728699 (Publication Type: Case Reports, Journal Article)

Chemical References

• HLA Antigens

Topics

• Child
• Child, Preschool
• Chromosomes, Human, X (genetics)
• Diseases in Twins (genetics, immunology, therapy)
• Female
• HLA Antigens
• Hematopoietic Stem Cell Transplantation
• Humans
• Infant
• Infant, Newborn
• Male
• Pregnancy
• Severe Combined Immunodeficiency (genetics, immunology, therapy)
• Siblings
• Transplantation, Homologous
• Twins, Monozygotic
• Wiskott-Aldrich Syndrome (genetics, immunology, therapy)