Unrelated partially matched lymphocyte infusions in a patient with complete DiGeorge/CHARGE syndrome

:  We present an infant with cDGS overlapping with CHARGE syndrome, who suffered from T‐cell deficiency treated with screened healthy DLI from an unrelated donor (8/10 match). The first dose of DLI (1.1 × 106 CD3+/kg) was administered at the age of six months, the second one (0.9 × 106 CD3+/kg) 36 d...

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Veröffentlicht in:Pediatric transplantation 2007-06, Vol.11 (4), p.441-447
Hauptverfasser: Janda, Ales, Sedlacek, Petr, Mejstrikova, Ester, Zdrahalova, Katerina, Hrusak, Ondrej, Kalina, Tomas, Sieglova, Zuzana, Zizkova, Hana, Formankova, Renata, Keslova, Petra, Hubacek, Petr, Sediva, Anna, Bartunkova, Jirina, Dlask, Karel, Stary, Jan
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Sprache:eng
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Zusammenfassung::  We present an infant with cDGS overlapping with CHARGE syndrome, who suffered from T‐cell deficiency treated with screened healthy DLI from an unrelated donor (8/10 match). The first dose of DLI (1.1 × 106 CD3+/kg) was administered at the age of six months, the second one (0.9 × 106 CD3+/kg) 36 days later. No conditioning was employed, GvHD prophylaxis consisting of CsA was used only during the second infusion. Since day+10 after the first DLI, split chimerism showing T‐cell engraftment has been documented. Proliferative response to PHA was detected on day+145. The treatment was complicated by severe acute GvHD (grade II‐III) after the first DLI and prolonged chronic liver cholestatic GvHD developing after the second DLI. Vigorous EBV proliferation four wk after the second DLI was accompanied by peripheral expansion of CD8+ donor cells. The patient, 26‐months old, is clinically well and has slowly started to gain his developmental milestones. We believe that infusions of small doses of DLI from an unrelated donor represent a potentially helpful therapeutic option in patients with cDGS/CHARGE phenotype.
ISSN:1397-3142
1399-3046
DOI:10.1111/j.1399-3046.2007.00702.x