Primary graft failure following unrelated cord blood transplantation with high-dose of CD34 + cells in the treatment of AML/MDS
10.3969/j.issn.1674-7445.2014.06.003
- VernacularTitle:含高剂量 CD34＋细胞的非血缘脐血移植治疗 AML/MDS 后原发植入失败
- Author:
Xiaoxi LU
1
;
Zhi WAN
;
Zhigui MA
;
Ju GAO
;
Yiping ZHU
Author Information
1. 四川大学华西第二医院儿科血液肿瘤科
- Keywords:
Human leukocyte antigen;
Mismatch;
Cord blood transplantation;
Hematopoietic stem cell transplantation;
Donor-specific antibody
- From:
Organ Transplantation
2014;(6):343-347
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analysis the cause of primary graft failure of unrelated cord blood transplantation with high-dose of CD34 + cells in treatment of acute myelocytic leukemia (AML) /myelodysplastic syndrome (MDS).Methods A 4-year-old girl was diagnosed AML/MDS at the Department of Pediatric Hematology and Oncology of West China Second University Hospital of Sichuan University. She presented completely remission after induction and consolidation chemotherapy.She received unrelated partially human leukocyte antigen (HLA)-mismatched cord blood transplantation.We investigated the treatment outcomes of UCBT and associated complications.Results The patient suffered primary graft failure and then received secondary haploidentical hematopoietic stem cell transplantation (HSCT)from her mother.However,she suffered fatal multiresistant Acinetobacter spp septicemia.She died due to respiratory failure on 7 d after the second transplantation.Conclusions In this case,hematopoietic stem cells with high dose of CD34 + cells could not overcome the risk of primary graft failure and HLA disparity.The patient's primary graft failure was associated with platelet transfusion refractoriness and potent immunologic dysfunction,especially the anti-HLA donor specific antibodies before unrelated cord blood transplantation.
