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Outcome of boost haemopoietic stem cell transplant for decresed donor chimerism or graft dysfunction in primary immunodeficiency

Lookup NU author(s): Professor Mary Slatter, Dr Mario Abinun, Dr Terence Flood, Professor Andrew Cant, Professor Andrew GenneryORCiD


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Haemopoietic stem cell transplants (HSCT) cure increasing numbers of primary immunodeficiencies (PID): residual recipient T-cell function increases risk of incomplete or decreasing immune reconstitution, which may resolve following a second, unconditioned, infusion from the same donor (boost infusion). We assessed the outcome of 20 boost infusions in 19/139 patients transplanted for PID patients at our centre since 1987. Boost infusion was given 64-1226 days after the original HSCT. Follow-up was 4-124 months. In all, 12 of 19 patients cleared viral infection (6), or showed sustained increase in donor chimerism, T- and B-cell numbers and function, or other markers (6). In 7/12 patients, immunoglobulin replacement has been discontinued. Four were partially successful with stable low-level chimerism (two patients) or improved T-cell function, but not B cell function (two patients). Four failed with no change in donor chimerism or cell number. No significant association with donor source, T-cell depletion, conditioning regimen, boost infusion stem cell dose or time from original HSCT to boost was found. One patient developed grade III acute graft-versus-host disease despite cyclosporine, and one developed severe pneumonitis; both have recovered. Boost infusion was successful or partially successful in 84% of patients. The risk of adverse effects is low. © 2005 Nature Publishing Group All rights reserved.

Publication metadata

Author(s): Slatter MA, Bhattacharya A, Abinun M, Flood TJ, Cant AJ, Gennery AR

Publication type: Article

Publication status: Published

Journal: Bone Marrow Transplantation

Year: 2005

Volume: 35

Issue: 7

Pages: 683-689

ISSN (print): 0268-3369

ISSN (electronic): 1476-5365

Publisher: Nature Publishing Group


DOI: 10.1038/sj.bmt.1704872

PubMed id: 15723084


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