Sustained and full fetal hemoglobin production after failure of bone marrow transplant in a patient homozygous for beta 0‐thalassemia: A clinical remission despite genetic disease and transplant rejection

An adult patient affected by β0‐thalassemia major underwent allogeneic bone marrow transplant (BMT) from a matched related donor. Forty days after transplant, allogeneic engraftment failure and autologous β0‐thalassemic bone marrow recovery were documented. Red blood cell transfusions were required until 118 days post‐transplant. Thereafter, the haemoglobin (Hb) levels stabilized over 11.8 gr/dl throughout the ongoing 34‐month follow‐up, abolishing the need for transfusion support. The Hb electrophoresis showed 100% Hb Fetal (HbF). This unexplained case suggests full HbF production may occur in an adult patient with β0‐thalassemia major. Am. J. Hematol. 2009. © 2009 Wiley‐Liss, Inc.