Two Cases of Severe Lung Complication Associated with GVHD after Stem Cell Transplantation from the Non-Inherited Maternal Antigen (NIMA) -Mismatched Sibling Donor

• Published in: The Japanese Journal of Pediatric Hematology Vol. 22; no. 1; pp. 21 - 27
• Main Authors: GOTO, Hiroaki, YOKOTA, Shumpei, YOKOSUKA, Tomoko, YANAGIMACHI, Masakatsu, FUJII, Hisaki, TAKAHASHI, Hiroyuki, KUROKI, Fumiko, MINAI, Amane
• Format: Journal Article
• Language: Japanese
• Published: THE JAPANESE SOCIETY OF PEDIATRIC HEMATOLOGY/ONCOLOGY 2008; 特定非営利活動法人 日本小児血液・がん学会
• Subjects: acute tapering of immunosuppressant; donor lymphocyte infusion (DLI); graft-versus-host disease; non-inherited maternal antigen (NIMA)
• ISSN: 0913-8706; 1884-4723
• DOI: 10.11412/jjph1987.22.21

In the selection of alternative donors for stem cell transplantation (SCT), if an HLA full-match donor can not be secured, the identity of the most appropriate donor is unclear. We experienced two children with refractory, acute myeloblastic leukemia (AML) who underwent SCT from the non-inherited maternal antigen (NIMA) -mismatched sibling donor linked with long-term feto-maternal microchimerism, with expectation of graft-versusleukemia (GVL) effect. The engraftments were speedy and acute graft-versus-host disease (GVHD) did not occur. But after donor lymphocyte infusion (DLI) or acute tapering of their immunosuppressant, severe lung complication with GVHD occurred in both cases. Our cases suggest the risk of immunotherapy after SCT from a NIMA-mismatched sibling donor.