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HLA-haploidentical bone marrow transplantation for severe combined
immunodeficiency using E rosette fractionation and cyclosporine
A Fischer, A Durandy, JP de Villartay, E Vilmer, F Le Deist, I Gerota and C Griscelli
Eight patients with severe combined immunodeficiency received bone marrow
cells from their HLA haplotype-identical fathers after bone marrow T cell
depletion by rosetting with neuraminidase-treated sheep red cells. Because
the method led to the infusion of a small percentage of T lymphocytes (0.1%
to 0.3%), cyclosporin was given by continuous intravenous infusion for two
months in order to prevent the occurrence of graft-v-host disease (GVHD).
Three patients who did have residual nonfunctional T lymphocytes received
busulfan and cyclophosphamide before transplantation. Engraftment was
observed in seven patients, and severe GVHD was not seen. Two patients died
early after the bone marrow transplantation because of prior infections,
and a third died at day 90 from a B cell lymphoproliferative syndrome. The
five other patients are doing well. Stable engraftment has been achieved
with reconstitution of cell-mediated immunity in 5/5 and humoral immunity
in 4/5 patients.
Volume 67,
Issue 2,
pp. 444-449,
02/01/1986
Copyright © 1986 by The American Society of Hematology
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