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Blood, 1 May 2004, Vol. 103, No. 9, pp. 3582-3589.
Prepublished online as a Blood First Edition Paper on January 8, 2004; DOI 10.1182/blood-2003-11-4008.

Submitted November 24, 2003
Accepted December 30, 2003
Very low levels of donor CD18+ neutrophils following allogeneic hematopoietic stem cell transplantation reverses the disease phenotype in canine leukocyte adhesion deficiency
Thomas R Bauer*, Kate E Creevy, Yu-chen Gu, Laura M Tuschong, Robert E Donahue, Mark E Metzger, Lisa J Embree, Tanya Burkholder, John D Bacher, Chris Romines, Marvin L Thomas, Lyn Colenda, and Dennis D Hickstein
Experimental Transplantation and Immunology Branch, National Cancer Institute, NIH, Bethesda, MD, USA
Hematology Branch, National Heart, Lung, Blood Institute, NIH, Rockville, MD, USA
Office of Research Services, Veterinary Resources Program, NIH, Bethesda, MD, USA
* Corresponding author; email: bauert{at}mail.nih.gov.
Children with the severe phenotype of the genetic immunodeficiency disease leukocyte adhesion deficiency or LAD experience life-threatening bacterial infections due to molecular defects in the leukocyte integrin CD18 molecule and the resultant failure to express the CD11/CD18 adhesion molecules on the leukocyte surface. Hematopoietic stem cell transplantation remains the only definitive therapy for LAD, however the degree of donor chimerism, and particularly the number of CD18+ donor-derived neutrophils required to reverse the disease phenotype, are not known. We performed non-myeloablative hematopoietic stem cell transplants from normal matched littermates in nine dogs with the canine form of LAD known as CLAD, and demonstrate that in the three dogs with the lowest level of donor chimerism, less than 500 CD18+ donor-derived neutrophils per µL in the peripheral blood of the CLAD recipients, resulted in reversal of the CLAD disease phenotype. These results demonstrate the value of a disease-specific, large animal model for identifying the lowest therapeutic level required for successful cellular and gene therapy.

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