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Allogeneic hematopoietic cell transplantation is curative in CARMIL2 deficiency

Lookup NU author(s): Dr Venetia BigleyORCiD, Dr Christo TsilifisORCiD

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Abstract

Biallelic loss-of-function variants in Capping protein regulator and myosin 1 linker 2(CARMIL2) cause a complex disorder of immune dysregulation hallmarked bysusceptibility to infections, inflammatory bowel and skin disease, and Epstein–Barrvirus-positive smooth muscle tumors (EBV+ SMTs). We report a multicenterretrospective study to evaluate hematopoietic cell transplantation (HCT) outcomes inCARMIL2-deficient patients. Seventeen patients underwent 19 HCTs, with a totalfollow-up of 768 months and a median follow-up of 37 months (range, 1–195). Threepatients died during the early post-transplant period (overall survival, 82.4%), and tworequired a second HCT for graft failure. Despite limitations due to cohort size and highmorbidity in individual patients, HCT improved all major disease manifestations,including infections, inflammatory disease, and previously treatment-refractory EBV+SMTs. No patient required immunoglobulin replacement post-HCT and no detrimentaleffects of mixed chimerism were noted. Allogeneic HCT is therefore a curative optionfor patients with CARMIL2 deficiency, which should be offered upon diagnosis.


Publication metadata

Author(s): Raedler J, Gothe F, Magg T, Peters P, Martinsen KHB, Holzer U, Kiykim A, Ucar AK, Abraham RS, Rangarajan HG, Eddin AN, Stepensky P, Zaidman I, Even-Or E, Kuehl J-S, Graefe D, Bigley V, Tsilifis C, Fasth A, Mahlaoui N, Wegehaupt O, Speckmann C, Casanova J-L, Klein C, Neven B, Beizt V, Levy R, Hauck F

Publication type: Article

Publication status: Published

Journal: Journal of Human Immunity

Year: 2026

Volume: 2

Issue: 5

Print publication date: 07/09/2026

Online publication date: 29/07/2026

Acceptance date: 08/07/2026

Date deposited: 09/07/2026

ISSN (electronic): 3065-8993

Publisher: Rockefeller University Press

URL: https://doi.org/10.70962/jhi.20250200

DOI: 10.70962/jhi.20250200

Data Access Statement: Deidentified data or a copy of the online survey may be available upon reasonable request by email to the corresponding author.


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Funding

Funder referenceFunder name
"Foerderprogramm fuer Forschung und Lehre" (1149), Faculty of Medicine, LMU Munich, Germany
Else Kröner-Fresenius Stiftung (2017_A110)
German Federal Ministry of Education and Research (BMBF 01GM2206D)
French National Research Agency (ANR CARMIL2; ANR-21-CE15-0034)
German Society for Allergology and Clinical Immunology (DGAKI; clinician scientist program TRIAL)
ITMO Cancer of Aviesan and INCa within the framework of the 2021–2030 Cancer Control Strategy (funds administered by Institut National de la Santé et de la Recherche Médicale)
Robert Debré association
Schlumberger Foundation for teaching and research (FSER202302017062)

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