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Successful treatment of autoimmune hemolytic anemia with rituximab in a child with severe combined immunodeficiency following nonidentical T-cell-depleted bone marrow transplantation

Bone Marrow Transplantation volume 35, pages 819–821 (2005)Cite this article

HLA nonidentical T-cell-depleted (TCD) BMT has been a curative therapy for a large number of children with Severe Combined Immunodeficiency Disorders (SCID).1 In half of these cases, deficient B-cell function persists after transplantation.1 The prospects of their survival are related to long-term immune reconstitution.1

A 13-month-old boy diagnosed with SCID with a T-B+NK+ phenotype was referred for BMT in April, 2000. A two-antigen mismatched TCD BMT from his father was performed. Both the recipient and the donor's blood group were A+. Conditioning consisted of busulfan (8 mg/kg), cyclophosphamide (200 mg/kg) and rabbit antithymocyte globulin (30 mg/kg). The graft was TCD by means of soybean lectin agglutination and double E-rosetting. Although the patient had an uneventful post-transplant outcome, he failed to achieve T-cell reconstitution. At 5 months after the first transplant, he underwent a second TCD BMT from the same donor after conditioning with busulfan and cyclophosphamide. Cyclosporin A was administered for GVHD prophylaxis for 6 months. On day +34, he developed intestinal acute GVHD, which resolved after treatment with methylprednisolone and ocreotide. On day +140, he experienced diarrhea and skin rash, which were diagnosed as chronic GVHD by biopsy. He received a second course of prednisone, which resulted in amelioration of clinical manifestations.

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Authors and Affiliations

  1. Hematology/Oncology Department and Hematopoietic Stem Cell Transplantation Unit, Hospital de Pediatría ‘Prof Dr Juan P Garrahan’, Combate de los Pozos 1881, Buenos Aires, C1245AAM, Argentina

    M Bonduel & C Figueroa

  2. Immunology Department, Hospital de Pediatría ‘Prof Dr Juan P Garrahan’, Buenos Aires, Argentina

    M Zelazko & J Rossi

  3. Transfusion Medicine Service, Hospital de Pediatría ‘Prof Dr Juan P Garrahan’, Buenos Aires, Argentina

    G Magaldi & A del Pozo

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  1. M Bonduel
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  2. M Zelazko
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  3. C Figueroa
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  4. G Magaldi
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  5. J Rossi
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  6. A del Pozo
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Bonduel, M., Zelazko, M., Figueroa, C. et al. Successful treatment of autoimmune hemolytic anemia with rituximab in a child with severe combined immunodeficiency following nonidentical T-cell-depleted bone marrow transplantation. Bone Marrow Transplant 35, 819–821 (2005). https://doi.org/10.1038/sj.bmt.1704885

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  • DOI: https://doi.org/10.1038/sj.bmt.1704885

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