Multicenter survey on the outcome of transplantation of hematopoietic cells in patients with the complete form of DiGeorge anomaly

A Janda, P Sedlacek, M Hönig… - Blood, The Journal …, 2010 - ashpublications.org
A Janda, P Sedlacek, M Hönig, W Friedrich, M Champagne, T Matsumoto, A Fischer…
Blood, The Journal of the American Society of Hematology, 2010ashpublications.org
Seventeen patients transplanted with hematopoietic cells to correct severe T lymphocyte
immunodeficiency resulting from complete DiGeorge anomaly were identified worldwide,
and retrospective data were obtained using a questionnaire-based survey. Patients were
treated at a median age of 5 months (range, 2-53 months) between 1995 and 2006. Bone
marrow was used in 11 procedures in 9 cases: 6 from matched unrelated donors, 4 from
human leukocyte antigen (HLA)-identical siblings, and one haploidentical parent with T-cell …
Abstract
Seventeen patients transplanted with hematopoietic cells to correct severe T lymphocyte immunodeficiency resulting from complete DiGeorge anomaly were identified worldwide, and retrospective data were obtained using a questionnaire-based survey. Patients were treated at a median age of 5 months (range, 2-53 months) between 1995 and 2006. Bone marrow was used in 11 procedures in 9 cases: 6 from matched unrelated donors, 4 from human leukocyte antigen (HLA)-identical siblings, and one haploidentical parent with T-cell depletion. Unmobilized peripheral blood was used in 8 cases: 5 from HLA-identical siblings, one from a matched unrelated donor, one from an HLA-identical parent, and one unrelated matched cord blood. Conditioning was used in 5 patients and graft-versus-host disease prophylaxis in 11 patients. Significant graft-versus-host disease occurred in 9 patients, becoming chronic in 3. Median length of follow-up was 13 months, with transplantation from HLA-matched sibling showing the best results. Median survival among deceased patients (10 patients) was 7 months after transplantation (range, 2-18 months). The overall survival rate was 41%, with a median follow-up of 5.8 years (range, 4-11.5 years). Among survivors, median CD3 and CD4 counts were 806 (range, 644-1224) and 348 (range, 225-782) cells/mm3, respectively, CD4+/CD45RA+ cells remained very low, whereas mitogen responses were normalized.
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