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Clinical and immunologic outcome of patients with cartilage hair hypoplasia after hematopoietic stem cell transplantation

Lookup NU author(s): Professor Andrew GenneryORCiD, Professor Mary Slatter, Professor Andrew Cant

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Abstract

Cartilage-hair hypoplasia (CHH) is a rare autosomal recessive disease caused by mutations in the RMRP gene. Beside dwarfism, CHH has a wide spectrum of clinical manifestations including variable grades of combined immunodeficiency, autoimmune complications, and malignancies. Previous reports in single CHH patients with significant immunodeficiencies have demonstrated that allogeneic hematopoietic stem cell transplantation (HSCT) is an effective treatment for the severe immunodeficiency, while growth failure remains unaffected. Because long-term experience in larger cohorts of CHH patients after HSCT is currently unreported, we performed a European collaborative survey reporting on 16 patients with CHH and immunodeficiency who underwent HSCT. Immune dysregulation, lymphoid malignancy, and autoimmunity were important features in this cohort. Thirteen patients were transplanted in early childhood (similar to 2.5 years). The other 3 patients were transplanted at adolescent age. Of 16 patients, 10 (62.5%) were long-term survivors, with a median follow-up of 7 years. T-lymphocyte numbers and function have normalized, and autoimmunity has resolved in all survivors. HSCT should be considered in CHH patients with severe immunodeficiency/autoimmunity, before the development of severe infections, major organ damage, or malignancy might jeopardize the outcome of HSCT and the quality of life in these patients. (Blood. 2010; 116(1): 27-35)


Publication metadata

Author(s): Bordon V, Gennery AR, Slatter MA, Vandecruys E, Laureys G, Veys P, Waseem Q, Friedrich W, Wulfraat NM, Scherer F, Cant AJ, Fischer A, Cavazanna-Calvo M, Bredius RGM, Notarangelo LD, Mazzolari E, Neven B, Tayfun G

Publication type: Article

Publication status: Published

Journal: Blood

Year: 2010

Volume: 116

Issue: 1

Pages: 27-35

Print publication date: 07/04/2010

ISSN (print): 0006-4971

ISSN (electronic): 1528-0020

Publisher: American Society of Hematology

URL: http://dx.doi.org/10.1182/blood-2010-01-259168

DOI: 10.1182/blood-2010-01-259168


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