Two Cases of Severe Lung Complication Associated with GVHD after Stem Cell Transplantation from the Non-Inherited Maternal Antigen (NIMA) -Mismatched Sibling Donor
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 ma...
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| Published in | The Japanese Journal of Pediatric Hematology Vol. 22; no. 1; pp. 21 - 27 |
|---|---|
| Main Authors | , , , , , , , |
| 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 | |
| Online Access | Get full text |
| ISSN | 0913-8706 1884-4723 |
| DOI | 10.11412/jjph1987.22.21 |
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| Abstract | 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. |
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| AbstractList | 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.
造血幹細胞移植 (SCT) が必要な症例においてHLA一致骨髄ドナーが得られない場合, 代替ドナーの選択基準は必ずしも明らかではない.当科では移植片対白血病 (GVL) 効果誘導を期待して, HLA一致骨髄ドナーが得られなかった2例の小児再発急性骨髄性白血病患者に対し, 母子間マイクロキメリズム陽性を確認したnon-inherited maternal antigen (NIMA) 相補的同胞からのSCTを施行した.いずれの症例でも速やかな生着が得られ, 初期には重症移植片対宿主病 (GVHD) の発症はみられなかったが, ドナーリンパ球輸注療法や免疫抑制剤の急速減量に伴い重症肺GVHDを発症した.NIMA相補的同胞からの移植後免疫療法の危険性が示唆された. 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. |
| Author | YOKOTA, Shumpei YOKOSUKA, Tomoko GOTO, Hiroaki KUROKI, Fumiko TAKAHASHI, Hiroyuki FUJII, Hisaki MINAI, Amane YANAGIMACHI, Masakatsu |
| Author_FL | 黒木 文子 横須賀 とも子 薬袋 周 柳町 昌克 横田 俊平 高橋 浩之 藤井 久紀 後藤 裕明 |
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| References | 19) Ferster A, Bujan W, Mouraux T, et al : Complete remission following donor leukocyte infusion in ALL relapsing after haploidentical bone marrow transplantation. Bone Marrow Transplant 14 : 331-332, 1994 17) Or R, Hadar E, Bitan M, et al : Safety and efficacy of donor lymphocyte infusions following mismatched stem cell transplantation. Biol Blood Marrow Transplant 12 : 1295-1301, 2006 2) Yoshihara T, Okada K, Kobayashi M, et al : Outcome of non-T-cell-depleted HLA-haploidentical hematopoietic stem cell transplantation from family donors in children and adolescents. Int J Hematol 85 : 246-255, 2007 12) Huang XJ, Liu DH, Liu KY, et al : Donor lymphocyte infusion for the treatment of leukemia relapse after HLAmismatched/haploidentical T-cell-replete hematopoieticstem cell transplantation. Haematologica 92 : 414-417, 2007 9) Linus H, Tomas S, Fausto R, et al : Risk factors for bronchiolitis obliterans in allogenic hematopoietic stemcell transplantation for leukemia. Chest 128 : 153-161, 2005 1) 日本造血幹細胞移植学会平成17年度全国調査報告書 www.jshct.com/report_2005/index.html 11) Lacerda JF, Martins C, Carmo JA, et al : Haploidentical stem cell transplantation with purified CD34 cells after a chemotherapy-alone conditioning regimen. Biol Blood Marrow Transplant 9 : 633-642, 2003 8) Schultz KR, Green GJ, Wensley D, et al : Obstructive lung disease in children after allogenic bone marrow transplantation. Blood 84 : 3212-3220, 1994 13) 玉木茂久, 一戸辰夫, 内山卓, 他 : NIMA相補的血縁者間造血細胞移植に関する後方視的全国調査 (中間報告-2).厚生労働科学研究費補助金.ヒトゲノム・再生医療等研究事業総合・総括・分担研究報告書 (平成14年度) : 227, 2002 14) Pagano L, Offidani M, Fianchi L, et al : Mucormycosis in hematologic patients. Haematologica 89 : 207-214, 2004 5) Estey E, Thall P, Andreeff M, et al : Use of granulocyte colony-stimulating factor before, during, and after fludarabine plus cytarabine induction therapy of newly diagnosed acute myelogenous leukemia or myelodysplastic syndromes : Comparison with fludarabine plus cytarabine without granulocyte colonystimulating factor. J Clin Oncol 12 : 671-678, 1994 6) Yates B, Murphy DM, Forrest IA, et al : Azithromycin reverses airflow obstruction in established bronchiolitia obliterans syndrome. Am J Respir Crit Care Med 172 : 772-775, 2005 3) van Rood JJ, Loberiza FR, Jr, Zhang MJ, et al : Effect of tolerance to noninherited maternal antigens on the occurrence of graft-versus-host disease after bone marrow transplantation from a parent or an HLA-haploidentical sibling. Blood 99 : 1572-1577, 2002 4) 丸屋悦子 : 母児免疫寛容と造血幹細胞移植.日本内科学会雑誌 94 : 1362-1368, 2005 7) Afessa B, Litzow MR, Tefferi A : Bronchiolitis obliterans and other late onset non-infectious pulmonary complications in hematopoietic stem cell transplantation. Bone Marrow Transplantation 28 : 425-434, 2001 10) Yoshihara S, Tateishi U, Ando T, et al : Lower incidence of bronchiolitis obliterans in allogenic hematopoietic stem cell transplantation with reduced-intensity conditioning compared with myeloablative conditioning. Bone marrow transplant 35 : 1195-1200, 2005 18) 塩原信太郎 : DLIの適応と方法.血液・腫瘍科 42 : 151-157, 2001 15) 大坂顯通, 大戸斉, 菊田敦, 他 : 安全な穎粒球輸血を目指したガイドライン案の作成.日本輸血学会雑誌 50 : 739-745, 2004 16) Ichinohe T, Uchiyama T, Shimazaki C, et al : Feasibility of HLA-haploidentical hematopoietic stem cell transplantation between noninherited maternal antigen (NIMA) -mismatched family members linked with longterm fetomaternal microchimerism. Blood 104 : 3821-3828, 2004 |
| References_xml | – reference: 10) Yoshihara S, Tateishi U, Ando T, et al : Lower incidence of bronchiolitis obliterans in allogenic hematopoietic stem cell transplantation with reduced-intensity conditioning compared with myeloablative conditioning. Bone marrow transplant 35 : 1195-1200, 2005 – reference: 3) van Rood JJ, Loberiza FR, Jr, Zhang MJ, et al : Effect of tolerance to noninherited maternal antigens on the occurrence of graft-versus-host disease after bone marrow transplantation from a parent or an HLA-haploidentical sibling. Blood 99 : 1572-1577, 2002 – reference: 13) 玉木茂久, 一戸辰夫, 内山卓, 他 : NIMA相補的血縁者間造血細胞移植に関する後方視的全国調査 (中間報告-2).厚生労働科学研究費補助金.ヒトゲノム・再生医療等研究事業総合・総括・分担研究報告書 (平成14年度) : 227, 2002 – reference: 12) Huang XJ, Liu DH, Liu KY, et al : Donor lymphocyte infusion for the treatment of leukemia relapse after HLAmismatched/haploidentical T-cell-replete hematopoieticstem cell transplantation. Haematologica 92 : 414-417, 2007 – reference: 5) Estey E, Thall P, Andreeff M, et al : Use of granulocyte colony-stimulating factor before, during, and after fludarabine plus cytarabine induction therapy of newly diagnosed acute myelogenous leukemia or myelodysplastic syndromes : Comparison with fludarabine plus cytarabine without granulocyte colonystimulating factor. J Clin Oncol 12 : 671-678, 1994 – reference: 7) Afessa B, Litzow MR, Tefferi A : Bronchiolitis obliterans and other late onset non-infectious pulmonary complications in hematopoietic stem cell transplantation. Bone Marrow Transplantation 28 : 425-434, 2001 – reference: 6) Yates B, Murphy DM, Forrest IA, et al : Azithromycin reverses airflow obstruction in established bronchiolitia obliterans syndrome. Am J Respir Crit Care Med 172 : 772-775, 2005 – reference: 8) Schultz KR, Green GJ, Wensley D, et al : Obstructive lung disease in children after allogenic bone marrow transplantation. Blood 84 : 3212-3220, 1994 – reference: 4) 丸屋悦子 : 母児免疫寛容と造血幹細胞移植.日本内科学会雑誌 94 : 1362-1368, 2005 – reference: 16) Ichinohe T, Uchiyama T, Shimazaki C, et al : Feasibility of HLA-haploidentical hematopoietic stem cell transplantation between noninherited maternal antigen (NIMA) -mismatched family members linked with longterm fetomaternal microchimerism. Blood 104 : 3821-3828, 2004 – reference: 11) Lacerda JF, Martins C, Carmo JA, et al : Haploidentical stem cell transplantation with purified CD34 cells after a chemotherapy-alone conditioning regimen. Biol Blood Marrow Transplant 9 : 633-642, 2003 – reference: 14) Pagano L, Offidani M, Fianchi L, et al : Mucormycosis in hematologic patients. Haematologica 89 : 207-214, 2004 – reference: 15) 大坂顯通, 大戸斉, 菊田敦, 他 : 安全な穎粒球輸血を目指したガイドライン案の作成.日本輸血学会雑誌 50 : 739-745, 2004 – reference: 1) 日本造血幹細胞移植学会平成17年度全国調査報告書 www.jshct.com/report_2005/index.html – reference: 2) Yoshihara T, Okada K, Kobayashi M, et al : Outcome of non-T-cell-depleted HLA-haploidentical hematopoietic stem cell transplantation from family donors in children and adolescents. Int J Hematol 85 : 246-255, 2007 – reference: 9) Linus H, Tomas S, Fausto R, et al : Risk factors for bronchiolitis obliterans in allogenic hematopoietic stemcell transplantation for leukemia. Chest 128 : 153-161, 2005 – reference: 19) Ferster A, Bujan W, Mouraux T, et al : Complete remission following donor leukocyte infusion in ALL relapsing after haploidentical bone marrow transplantation. Bone Marrow Transplant 14 : 331-332, 1994 – reference: 18) 塩原信太郎 : DLIの適応と方法.血液・腫瘍科 42 : 151-157, 2001 – reference: 17) Or R, Hadar E, Bitan M, et al : Safety and efficacy of donor lymphocyte infusions following mismatched stem cell transplantation. Biol Blood Marrow Transplant 12 : 1295-1301, 2006 |
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| SubjectTerms | acute tapering of immunosuppressant donor lymphocyte infusion (DLI) graft-versus-host disease non-inherited maternal antigen (NIMA) |
| Title | Two Cases of Severe Lung Complication Associated with GVHD after Stem Cell Transplantation from the Non-Inherited Maternal Antigen (NIMA) -Mismatched Sibling Donor |
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