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Anantharachagan A, Loh SY, Burns SO, Laurence A, Tadros S, Tholouli E, Lwin Y, Martinez-Calle N, Vaitla P, Morris EC. Allogeneic hematopoietic stem cell transplantation outcome in oldest known surviving patients with Wiskott-Aldrich syndrome. J Allergy Clin Immunol Glob 2024; 3:100191. [PMID: 38187865 PMCID: PMC10770606 DOI: 10.1016/j.jacig.2023.100191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 09/01/2023] [Accepted: 09/08/2023] [Indexed: 01/09/2024]
Abstract
Regardless of their age, adult patients with Wiskott-Aldrich syndrome should be considered for hematopoietic stem cell transplantation if clinically indicated.
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Affiliation(s)
- Ariharan Anantharachagan
- Department of Allergy and Clinical Immunology, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, United Kingdom
- Department of Immunology, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, United Kingdom
| | - Sook Yin Loh
- Department of Allergy and Clinical Immunology, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, United Kingdom
| | - Siobhan O. Burns
- University College London Institute of Immunity and Transplantation, London, United Kingdom
- Department of Immunology, The Royal Free London NHS Foundation Trust, London, United Kingdom
| | - Arian Laurence
- University College London Institute of Immunity and Transplantation, London, United Kingdom
- Department of Immunology, The Royal Free London NHS Foundation Trust, London, United Kingdom
- Department of Clinical Haematology, University College London NHS Foundation Trust, London, United Kingdom
| | - Susan Tadros
- Department of Immunology, The Royal Free London NHS Foundation Trust, London, United Kingdom
| | - Eleni Tholouli
- Manchester University NHS Foundation Trust, Department of Haematology, Manchester, United Kingdom
| | - Yadanar Lwin
- Department of Haematology, Nottingham, United Kingdom
| | | | - P. Vaitla
- Department of Immunology Nottingham University Hospitals, NHS Trust, Nottingham, United Kingdom
| | - Emma C. Morris
- University College London Institute of Immunity and Transplantation, London, United Kingdom
- Department of Immunology, The Royal Free London NHS Foundation Trust, London, United Kingdom
- Department of Clinical Haematology, University College London NHS Foundation Trust, London, United Kingdom
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Arnold DE, Pai SY. Progress in the field of hematopoietic stem cell-based therapies for inborn errors of immunity. Curr Opin Pediatr 2023; 35:663-670. [PMID: 37732933 PMCID: PMC10872717 DOI: 10.1097/mop.0000000000001292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
PURPOSE OF REVIEW Hematopoietic stem cell-based therapies, including allogeneic hematopoietic cell transplantation (HCT) and autologous gene therapy (GT), have been used as curative therapy for many inborn errors of immunity (IEI). As the number of genetically defined IEI and the use of HCT and GT increase, valuable data on outcomes and approaches for specific disorders are available. We review recent progress in HCT and GT for IEI in this article. RECENT FINDINGS Novel approaches to prevention of allogeneic complications and experience in adolescents and young adults have expanded the use of HCT. Universal newborn screening for severe combined immunodeficiency (SCID) has led to improved outcome after HCT. Analysis of outcomes of HCT and GT for SCID, Wiskott-Aldrich syndrome (WAS) and chronic granulomatous disease (CGD) reveal risk factors for survival, the impact of specific conditioning regimens, and vector- or disease-specific impacts on efficacy and safety. Preclinical studies of GT and gene editing show potential for translation to the clinic. SUMMARY Emerging data on outcome after HCT for specific IEI support early evaluation and treatment, before development of co-morbidities. Data in large cooperative retrospective databases continues to yield valuable insights clinicians can use in patient selection and choice of therapy.
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Affiliation(s)
- Danielle E. Arnold
- Immune Deficiency Cellular Therapy Program, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, USA
| | - Sung-Yun Pai
- Immune Deficiency Cellular Therapy Program, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, USA
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de Groot PF, Kwakernaak AJ, van Leeuwen EMM, van Spaendonk RML, Kooi EJ, de Jong D, Kuijpers TW, Zijlstra JM, de Bree GJ. Case report: XMEN disease: a patient with recurrent Hodgkin lymphoma and immune thrombocytopenia. Front Med (Lausanne) 2023; 10:1264329. [PMID: 38143450 PMCID: PMC10740371 DOI: 10.3389/fmed.2023.1264329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 11/08/2023] [Indexed: 12/26/2023] Open
Abstract
Here we present the case of a 28-year-old man with X-linked immunodeficiency with magnesium defect, Epstein-Barr virus (EBV) infection and neoplasia (XMEN) disease. He presented with immune thrombocytopenia within 1 year after successful autologous hematopoietic stem cell transplantation for recurrent EBV-associated classical Hodgkin lymphoma (CHL). The combination of EBV- associated malignancy, autoimmunity, recurrent airway infections at young age and bronchiectasis, prompted immunological investigation for an inborn error of immunity (IEI). Genetic testing revealed XMEN disease. XMEN disease is characterized by a glycosylation defect due to mutations in the MAGT1 gene. Germline mutations in the MAGT1 gene disrupt glycosylation of the NKG2D receptor in immune cells, including natural killer and CD8-positive T cells, vital for immune surveillance, especially against EBV. Consequently, individuals with XMEN disease, are prone to EBV-associated lymphoproliferative disorders in addition to auto-immunity. Early recognition of adult onset IEI-related B-lymphoproliferative disorders, including CHL is of vital importance for treatment decisions, including (allogeneic) haematopoietic stem cell transplantation and family screening.
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Affiliation(s)
- Pieter F. de Groot
- Division of Clinical Immunology and Allergy, Department of Internal Medicine, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Arjan J. Kwakernaak
- Division of Clinical Immunology and Allergy, Department of Internal Medicine, Amsterdam University Medical Centers, Amsterdam, Netherlands
- Department of Experimental Immunology, Amsterdam Institute for Infection and Immunity, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Ester M. M. van Leeuwen
- Department of Experimental Immunology, Amsterdam Institute for Infection and Immunity, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | | | - Evert-Jan Kooi
- Department of Pathology, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Daphne de Jong
- Department of Pathology, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Taco W. Kuijpers
- Department of Experimental Immunology, Amsterdam Institute for Infection and Immunity, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
- Department of Paediatric Immunology, Infectious Diseases and Rheumatology, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Josée M. Zijlstra
- Division of Haematology, Department of Internal Medicine, Cancer Center Amsterdam, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Godelieve J. de Bree
- Department of Experimental Immunology, Amsterdam Institute for Infection and Immunity, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
- Division of Infectious Diseases, Department of Internal Medicine, Amsterdam University Medical Centers, Amsterdam, Netherlands
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