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Blood, 1 July 2005, Vol. 106, No. 1, pp. 40-42.
Prepublished online as a Blood First Edition Paper on March 24, 2005; DOI 10.1182/blood-2005-01-0319.
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Submitted January 25, 2005
Accepted March 2, 2005
Progressive neurological dysfunctions twenty years after allogeneic bone-marrow transplantation for Chediak-Higashi syndrome
Marc Tardieu*, Catherine Lacroix, Benedicte Neven, Pierre Bordigoni, Genevieve de Saint Basile, Stephane Blanche, and Alain Fischer
Service de Neurologie, Departement de Pediatrie et Laboratoire de Neuropathologie, Hopital Bicetre, Assistance Publique-Hopitaux de Paris, Le Kremlin Bicere, France
Unite d'Immunohematologie Pediatrique, Paris, France
Service de Pediatrie, Centre Hospitalier Universitaire, Nancy, France
INSERM U429, Hopital Necker, Assistance Publique-Hopitaux de Paris, Paris, France
Unite d'Immunohematologie Pediatrique, Paris, France; INSERM U429, Hopital Necker, Assistance Publique-Hopitaux de Paris, Paris, France
* Corresponding author; email: marc.tardieu{at}bct.ap-hop-paris.fr.
Three patients with Chediak-Higashi syndrome underwent allogeneic bone marrow transplantation between the ages of 2 9/12 and 7 years. The outcome was uneventful, with sustained mixed chimerism. No subsequent recurrent infections or hemophagocytic syndrome were observed. At the age of 22 to 24 years, these three patients developed a neurological deficit combining difficulty walking, loss of balance and tremor. Neurological evaluation demonstrated cerebellar ataxia and signs of peripheral neuropathy. Moderate axon loss and rarefaction of large myelinated fibers were observed on semi-thin sections of peripheral nerve. Cerebellar atrophy was detected by cerebral magnetic resonance imaging in two patients. We also reviewed the very long-term outcome of the other 11 patients with Chediak-Higashi syndrome who had received bone-marrow transplants at our center since 1981. All displayed neurological deficits or low cognitive abilities.

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