Abstract
A patient with severe combined immunodeficiency received seven transplants of bone marrow from an HLA-B-compatible and HLA-D-compatible unrelated donor in an attempt to provide immunologic reconstitution. The first 4 transplants achieved restricted engraftment with evidence of rudimentary immunologic function. A fifth transplant, given after low-dose cyclophosphamide, produced reconstitution of cell-mediated immunity. Marrow aplasia developed after recontamination with a non-pathogenic microflora. Transplantation of marrow previously stored in liquid nitrogen was ineffective. A subsequent transplant, administered after high-dose cyclophosphamide, achieved durable engraftment, with complete hematopoietic and immunologic reconstitution. Seventeen months after transplantation, full functional engraftment persists. Graft-versus-host disease has been chronic and moderately severe, but limited to the skin and oral mucosa. Transplantation of marrow from unrelated histocompatible donors may provide a useful treatment for patients with severe combined immunodeficiency or aplastic anemia who lack a mtched sibling or related donor.
| Original language | English |
|---|---|
| Pages (from-to) | 1311-1318 |
| Number of pages | 8 |
| Journal | New England Journal of Medicine |
| Volume | 297 |
| Issue number | 24 |
| State | Published - Dec 1 1977 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Medicine(all)
Cite this
Reconstitution in severe combined immunodeficiency by transplantation of marrow from an unrelated donor. / O'Reilly, R. J.; Dupont, B.; Pahwa, Savita G; Grimes, E.; Smithwick, E. M.; Pahwa, Rajendra; Schwartz, S.; Hansen, J. A.; Siegal, F. P.; Sorell, M.; Svejgaard, A.; Jersild, C.; Thomsen, M.; Platz, P.; L'Esperance, P.; Good, R. A.
In: New England Journal of Medicine, Vol. 297, No. 24, 01.12.1977, p. 1311-1318.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Reconstitution in severe combined immunodeficiency by transplantation of marrow from an unrelated donor
AU - O'Reilly, R. J.
AU - Dupont, B.
AU - Pahwa, Savita G
AU - Grimes, E.
AU - Smithwick, E. M.
AU - Pahwa, Rajendra
AU - Schwartz, S.
AU - Hansen, J. A.
AU - Siegal, F. P.
AU - Sorell, M.
AU - Svejgaard, A.
AU - Jersild, C.
AU - Thomsen, M.
AU - Platz, P.
AU - L'Esperance, P.
AU - Good, R. A.
PY - 1977/12/1
Y1 - 1977/12/1
N2 - A patient with severe combined immunodeficiency received seven transplants of bone marrow from an HLA-B-compatible and HLA-D-compatible unrelated donor in an attempt to provide immunologic reconstitution. The first 4 transplants achieved restricted engraftment with evidence of rudimentary immunologic function. A fifth transplant, given after low-dose cyclophosphamide, produced reconstitution of cell-mediated immunity. Marrow aplasia developed after recontamination with a non-pathogenic microflora. Transplantation of marrow previously stored in liquid nitrogen was ineffective. A subsequent transplant, administered after high-dose cyclophosphamide, achieved durable engraftment, with complete hematopoietic and immunologic reconstitution. Seventeen months after transplantation, full functional engraftment persists. Graft-versus-host disease has been chronic and moderately severe, but limited to the skin and oral mucosa. Transplantation of marrow from unrelated histocompatible donors may provide a useful treatment for patients with severe combined immunodeficiency or aplastic anemia who lack a mtched sibling or related donor.
AB - A patient with severe combined immunodeficiency received seven transplants of bone marrow from an HLA-B-compatible and HLA-D-compatible unrelated donor in an attempt to provide immunologic reconstitution. The first 4 transplants achieved restricted engraftment with evidence of rudimentary immunologic function. A fifth transplant, given after low-dose cyclophosphamide, produced reconstitution of cell-mediated immunity. Marrow aplasia developed after recontamination with a non-pathogenic microflora. Transplantation of marrow previously stored in liquid nitrogen was ineffective. A subsequent transplant, administered after high-dose cyclophosphamide, achieved durable engraftment, with complete hematopoietic and immunologic reconstitution. Seventeen months after transplantation, full functional engraftment persists. Graft-versus-host disease has been chronic and moderately severe, but limited to the skin and oral mucosa. Transplantation of marrow from unrelated histocompatible donors may provide a useful treatment for patients with severe combined immunodeficiency or aplastic anemia who lack a mtched sibling or related donor.
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M3 - Article
C2 - 21351
AN - SCOPUS:0017697285
VL - 297
SP - 1311
EP - 1318
JO - New England Journal of Medicine
JF - New England Journal of Medicine
SN - 0028-4793
IS - 24
ER -