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Ikeda T, Kawahara Y, Miyauchi A, Niijima H, Furukawa R, Shimozawa N, Morimoto A, Osaka H, Yamagata T. Low donor chimerism may be sufficient to prevent demyelination in adrenoleukodystrophy. JIMD Rep 2022; 63:19-24. [PMID: 35028267 PMCID: PMC8743339 DOI: 10.1002/jmd2.12259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 10/15/2021] [Accepted: 10/19/2021] [Indexed: 11/08/2022] Open
Abstract
Adrenoleukodystrophy (ALD) is a peroxisomal disorder characterized by white matter degeneration caused by adenosine triphosphate-binding cassette subfamily D member 1 (ABCD1) gene mutations, which lead to an accumulation of very-long-chain fatty acids (VLCFA). Hematopoietic stem cell transplantation (HSCT) is the most effective treatment; however, the ratio of donor-to-recipient cells required to prevent the progression of demyelination is unclear. The proband was diagnosed with the childhood cerebral form of ALD at 5 years of age based on the clinical phenotype, elevated plasma VLCFA levels, and pathogenic ABCD1 mutation c.293C>T (p.Ser98Leu). Soon after the diagnosis, he became bedridden. At 1 year of age, his younger brother was found to carry the same ABCD1 mutation; despite being asymptomatic, at 1 year and 9 months, head magnetic resonance imaging (MRI) showed high-signal-intensity lesions in the cerebral white matter. The patient underwent unrelated cord blood transplantation (UCBT) with a reduced conditioning regimen, which resulted in mixed chimerism. For 7 years after UCBT, the donor chimerism remained low (<10%) in peripheral blood and cerebrospinal fluid. However, even though a second HSCT was not performed, his neurological symptoms and brain MRI findings did not deteriorate. Our case suggests that even a small number of donor cells may prevent demyelination in ALD. This is an important case when considering the timing of a second HSCT.
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Affiliation(s)
- Takahiro Ikeda
- Department of PediatricsJichi Medical UniversityTochigiJapan
| | - Yuta Kawahara
- Department of PediatricsJichi Medical UniversityTochigiJapan
| | | | - Hitomi Niijima
- Department of PediatricsJichi Medical UniversityTochigiJapan
| | - Rieko Furukawa
- Department of RadiologyJichi Medical UniversityTochigiJapan
| | - Nobuyuki Shimozawa
- Division of Genomics Research, Life Science Research CenterGifu UniversityGifuJapan
| | - Akira Morimoto
- Department of PediatricsJichi Medical UniversityTochigiJapan
| | - Hitoshi Osaka
- Department of PediatricsJichi Medical UniversityTochigiJapan
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Lazzari L, Farina F, Lupo Stanghellini MT, Piemontese S, Marktel S, Mazzi B, Vago L, Milani R, Ferrario A, Bianchi B, Merli M, Ferreri AJM, Corti C, Peccatori J, Ruggeri A, Ciceri F. Graft-versus-lymphoma effect inside the central nervous system in a patient with extranodal natural killer/T-cell lymphoma, nasal type. Curr Res Transl Med 2021; 69:103313. [PMID: 34598023 DOI: 10.1016/j.retram.2021.103313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 08/30/2021] [Accepted: 09/18/2021] [Indexed: 11/17/2022]
Affiliation(s)
- Lorenzo Lazzari
- Hematology and Bone Marrow Transplantation Unit, IRCCS Ospedale San Raffaele, Milano, Italy.
| | - Francesca Farina
- Hematology and Bone Marrow Transplantation Unit, IRCCS Ospedale San Raffaele, Milano, Italy
| | | | - Simona Piemontese
- Hematology and Bone Marrow Transplantation Unit, IRCCS Ospedale San Raffaele, Milano, Italy
| | - Sarah Marktel
- Hematology and Bone Marrow Transplantation Unit, IRCCS Ospedale San Raffaele, Milano, Italy
| | - Benedetta Mazzi
- Immunohematology and Transfusion Medicine Unit, IRCCS Ospedale San Raffaele, Milano, Italy
| | - Luca Vago
- Hematology and Bone Marrow Transplantation Unit, IRCCS Ospedale San Raffaele, Milano, Italy; Immunohematology and Transfusion Medicine Unit, IRCCS Ospedale San Raffaele, Milano, Italy
| | - Raffaella Milani
- Immunohematology and Transfusion Medicine Unit, IRCCS Ospedale San Raffaele, Milano, Italy
| | - Andrea Ferrario
- Division of Hematology, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | - Benedetta Bianchi
- Division of Hematology, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | - Michele Merli
- Division of Hematology, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | | | - Consuelo Corti
- Hematology and Bone Marrow Transplantation Unit, IRCCS Ospedale San Raffaele, Milano, Italy
| | - Jacopo Peccatori
- Hematology and Bone Marrow Transplantation Unit, IRCCS Ospedale San Raffaele, Milano, Italy
| | - Annalisa Ruggeri
- Hematology and Bone Marrow Transplantation Unit, IRCCS Ospedale San Raffaele, Milano, Italy
| | - Fabio Ciceri
- Hematology and Bone Marrow Transplantation Unit, IRCCS Ospedale San Raffaele, Milano, Italy
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Mika T, Ladigan S, Baraniskin A, Vangala D, Seidel S, Hopfer O, Kiehl M, Schroers R. Allogeneic hematopoietic stem cell transplantation for primary central nervous system lymphoma. Haematologica 2019; 105:e160-e163. [PMID: 31399528 DOI: 10.3324/haematol.2019.227199] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- Thomas Mika
- Department of Hematology and Oncology, Universitätsklinikum Knappschaftskrankenhaus Bochum
| | - Swetlana Ladigan
- Department of Hematology and Oncology, Universitätsklinikum Knappschaftskrankenhaus Bochum
| | - Alexander Baraniskin
- Department of Hematology and Oncology, Universitätsklinikum Knappschaftskrankenhaus Bochum
| | - Deepak Vangala
- Department of Hematology and Oncology, Universitätsklinikum Knappschaftskrankenhaus Bochum
| | - Sabine Seidel
- Department of Neurology, Universitätsklinikum Knappschaftskrankenhaus Bochum
| | - Olaf Hopfer
- Department of Medicine I, Klinikum Frankfurt, Frankfurt (Oder), Germany
| | - Michael Kiehl
- Department of Medicine I, Klinikum Frankfurt, Frankfurt (Oder), Germany
| | - Roland Schroers
- Department of Hematology and Oncology, Universitätsklinikum Knappschaftskrankenhaus Bochum
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Pahari H, Nagai S, Skorupski S, Salgia R. Graft-versus-host disease of the central nervous system after liver transplantation: A rare complication. Am J Transplant 2018; 18:2591-2594. [PMID: 29935052 DOI: 10.1111/ajt.14981] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 06/04/2018] [Accepted: 06/12/2018] [Indexed: 01/25/2023]
Abstract
Graft-versus-host disease (GVHD) of the central nervous system (CNS) following solid organ transplantation is a rare but serious complication and has been previously reported after bone marrow transplantation. GVHD after liver transplantation is a rare entity with a high mortality rate. We report the case of a patient who developed GVHD and subsequently had seizures and altered mental status after deceased donor liver transplantation. The diagnosis of GVHD of the CNS was established by short tandem repeat loci analysis of the cerebrospinal fluid using the polymerase chain reaction technique and gene mapping software. To our knowledge, this is the first reported case of CNS-GVHD following liver transplantation. He eventually died of sepsis and multiorgan failure, in keeping with the overall poor prognosis of CNS-GVHD.
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Affiliation(s)
- Hirak Pahari
- Division of Transplant Surgery, Henry Ford Hospital, Detroit, MI, USA
| | - Shunji Nagai
- Division of Transplant Surgery, Henry Ford Hospital, Detroit, MI, USA
| | - Sharon Skorupski
- Transplant Immunology Laboratory, Henry Ford Hospital, Detroit, MI, USA
| | - Reena Salgia
- Division of Gastroenterology and Hepatology, Henry Ford Hospital, Detroit, MI, USA
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Spruit JL, Fagoaga OR, Savaşan S. Donor cell chimerism evaluation in cerebrospinal fluid by short tandem repeat analysis following allogeneic hematopoietic stem cell transplantation. Hum Immunol 2018; 79:537-538. [PMID: 29654803 DOI: 10.1016/j.humimm.2018.04.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 03/27/2018] [Accepted: 04/10/2018] [Indexed: 12/25/2022]
Abstract
Cerebrospinal fluid (CSF) cell count, morphology and flow cytometric evaluations are used to investigate central nervous system (CNS) involvement in leukemia/lymphoma. We performed CSF short tandem repeat (STR) analysis to monitor CSF chimerism status and evaluate for disease involvement in 11 asymptomatic pediatric allogeneic hematopoietic stem cell transplantation (HSCT) recipients with hemato-lymphoid neoplasms and high risk for or history of CNS involvement. Eighteen (64%) of the samples with median CSF cell count of 1/mm3 with 90% lymphocytes gave conclusive STR results, suggesting that this DNA-based method can be used in monitoring CSF chimerism status after HSCT with an acceptable yield.
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Affiliation(s)
- Jessica L Spruit
- Pediatric Blood and Marrow Transplantation, Children's Hospital of Michigan, 3901 Beaubien, Detroit, MI 48201, USA.
| | - Omar R Fagoaga
- Histocompatibility and Immunogenetics Lab, DMC University Laboratories, Hutzel/KEI Building, 4707 Saint Antoine Street, Detroit, MI 48201, USA; Wayne State University School of Medicine, 540 E Canfield Ave, Detroit, MI 48201, USA.
| | - Süreyya Savaşan
- Pediatric Blood and Marrow Transplantation, Children's Hospital of Michigan, 3901 Beaubien, Detroit, MI 48201, USA; Wayne State University School of Medicine, 540 E Canfield Ave, Detroit, MI 48201, USA; Barbara Ann Karmanos Cancer Center, 4100 John R Street, Detroit, MI 48201, USA.
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