A case report of myelodysplastic syndrome treated with allogeneic transplantation of HLA-identical sibling using culture-expanded mesenchymal stem cells and hematopoietic stem cells originated from HBV infected donor
10.3760/cma.j.issn.1009-9921.2010.09.005
- VernacularTitle:乙肝病毒感染供者来源异基因间充质干细胞联合非清髓性造血干细胞移植治疗骨髓增生异常综合征-难治性贫血一例
- Author:
Wenyi SHEN
;
Hua LU
;
Jianyong LI
;
Jianfu ZHANG
;
Jun LI
;
Donghui ZHOU
- Publication Type:Journal Article
- Keywords:
HBV infection;
Mensenchymal stem cell;
Hematopoietic stem cell;
Myelodysplastic syndrome;
Anemia,refractory
- From:
Journal of Leukemia & Lymphoma
2010;19(9):529-532
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the safety, efficiency and feasibility of HLA-identical sibling using culture-expanded mesenchymal stem cells and hematopoietic stem cells in treatment for myelodysplastic syndrome (MDS). Also to investigate for valid preventive measures to avoid the infection of HBV originated from donor. Methods A 46-years-old male patient with myelodysplastic syndrome-refractory anemia (MDSRA) got a cotransplantation of culture-expanded mensenchymal stem cells (MSC) and hematopoietic stem cells (HSCs) from HLA-identical sibling donor (his sister) who was infected by hepatitis B virus (HBV). Some measures were applicated in order to avoid the recipient from getting a HBV infection. The antiviral therapy to the donor was began early at the time 1 month before transplant, and HBV vaccine inoculation was used 2 month before transplant. High titer of anti-hepatis B immunoglobulin was used 1 week before transplant and 1 month after transplant the use of prophylactic anti-hepatis B drug treatment was begun. A non-myeloablative preparative regimen included fludarabine monophosphate (Flu, 120 mg/m2), cyclophosphamide (Cy, 1200 mg/m2)and antithymocyte globulin (ATG, 15 mg/kg) was given to him before culture-expanded mesenchymal stem cell and allogeneic peripheral blood stem cell from his HLA-matched sister. Results The regimen was well tolerated, and hemopoiesis was reconstituted on day 10 after transplant, idiochromosome detected by fluorescent in situ hybridization on day 30 showed XY 47/300 and on day 90 it was 7/300. No evidence of HBV infection was detected on day 60 after transplant. Conclusion The clinical course of this patient indicate that HLA-identical sibling culture-expanded mesenchymal stem cell transplantation combined with non-myeloablative stem cell transplantation can be an effective and safe approach in treatment of MDS.
