PMID- 16770250
OWN - NLM
STAT- MEDLINE
DCOM- 20060711
LR  - 20131121
IS  - 0041-1337 (Print)
IS  - 0041-1337 (Linking)
VI  - 81
IP  - 11
DP  - 2006 Jun 15
TI  - Serial transplantation resulting in tolerance to an unrelated cord blood graft.
PG  - 1596-9
AB  - Unrelated cord blood (UCB) hematopoietic stem cells were serially transplanted 
      into two human leukocyte antigen (HLA)-identical siblings with T cell, B cell, 
      natural killer cell severe combined immunodeficiency. Brother A received a 
      4/6-matched, HLA DRbeta1-identical but class I-disparate UCB graft after 
      myeloablative dosages of busulfan, melphalan, and antithymocyte globulin. He 
      experienced complete donor chimerism, severe acute gastrointestinal 
      graft-versus-host disease (GVHD), and limited chronic skin GVHD that resolved 
      with treatment. Two years later, brother B received unfractionated marrow from 
      brother A after reduced-intensity conditioning with cyclophosphamide and 
      antithymocyte globulin. Brother B experienced mixed-donor (i.e. original UCB) 
      chimerism and no histologically documented GVHD. Both brothers are clinically 
      well; brother A is in a fully immunologically reconstituted state. The uneventful 
      course and progressive increase in donor chimerism after the second 
      transplantation indicates that hematopoietic cells derived from the older 
      brother's marrow engrafted without causing GVHD, suggesting that acquired 
      tolerance to disparate unrelated HLA antigens was achieved.
FAU - Goebel, W Scott
AU  - Goebel WS
AD  - Department of Pediatrics and the Pediatric Stem Cell Transplantation Program, 
      Indiana University School of Medicine, Riley Hospital for Children, Indianapolis, 
      IN 46202-5200, USA. sgoebel2@iupui.edu
FAU - Nelson, Robert P Jr
AU  - Nelson RP Jr
FAU - Brahmi, Zacharie
AU  - Brahmi Z
FAU - Gowan, Darla J
AU  - Gowan DJ
FAU - Towell, Paula J
AU  - Towell PJ
FAU - Robertson, Kent A
AU  - Robertson KA
FAU - Haut, Paul R
AU  - Haut PR
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Transplantation
JT  - Transplantation
JID - 0132144
RN  - 0 (Antilymphocyte Serum)
RN  - 0 (HLA Antigens)
RN  - 0 (Immunosuppressive Agents)
RN  - 8N3DW7272P (Cyclophosphamide)
RN  - G1LN9045DK (Busulfan)
RN  - Q41OR9510P (Melphalan)
SB  - IM
MH  - Antilymphocyte Serum/therapeutic use
MH  - B-Lymphocytes/immunology
MH  - Bone Marrow Transplantation/immunology/*methods
MH  - Busulfan/therapeutic use
MH  - Chimerism
MH  - Cord Blood Stem Cell Transplantation/*methods
MH  - Cyclophosphamide/therapeutic use
MH  - Graft vs Host Disease/immunology
MH  - HLA Antigens/immunology
MH  - Humans
MH  - Immunosuppressive Agents/therapeutic use
MH  - Infant
MH  - Infant, Newborn
MH  - Killer Cells, Natural/immunology
MH  - Male
MH  - Melphalan/therapeutic use
MH  - Severe Combined Immunodeficiency/immunology/*therapy
MH  - Siblings
MH  - T-Lymphocytes/immunology
MH  - Transplantation Tolerance/drug effects/*immunology
EDAT- 2006/06/14 09:00
MHDA- 2006/07/13 09:00
CRDT- 2006/06/14 09:00
PHST- 2006/06/14 09:00 [pubmed]
PHST- 2006/07/13 09:00 [medline]
PHST- 2006/06/14 09:00 [entrez]
AID - 00007890-200606150-00015 [pii]
AID - 10.1097/01.tp.0000209659.59606.f2 [doi]
PST - ppublish
SO  - Transplantation. 2006 Jun 15;81(11):1596-9. doi: 
      10.1097/01.tp.0000209659.59606.f2.