Haematopoietic stem cell transplantation for inborn errors of immunity: 25-year experience from University of Malaya Medical Centre, Malaysia.

Autor: Ariffin H; Department of Paediatrics, University of Malaya, Kuala Lumpur, Malaysia.; Paediatric Haematology-Oncology and Bone Marrow Transplantation Unit, University of Malaya Medical Centre, Kuala Lumpur, Malaysia., Ab Rahman S; Paediatric Haematology-Oncology and Bone Marrow Transplantation Unit, University of Malaya Medical Centre, Kuala Lumpur, Malaysia., Jawin V; Department of Paediatrics, University of Malaya, Kuala Lumpur, Malaysia.; Paediatric Haematology-Oncology and Bone Marrow Transplantation Unit, University of Malaya Medical Centre, Kuala Lumpur, Malaysia., Foo JC; Department of Paediatrics, University of Malaya, Kuala Lumpur, Malaysia.; Paediatric Haematology-Oncology and Bone Marrow Transplantation Unit, University of Malaya Medical Centre, Kuala Lumpur, Malaysia., Amram NF; Paediatric Haematology-Oncology and Bone Marrow Transplantation Unit, University of Malaya Medical Centre, Kuala Lumpur, Malaysia., Mahmood NM; Department of Paediatrics, University of Malaya, Kuala Lumpur, Malaysia., Yap TY; Department of Paediatrics, University of Malaya, Kuala Lumpur, Malaysia.; Paediatric Haematology-Oncology and Bone Marrow Transplantation Unit, University of Malaya Medical Centre, Kuala Lumpur, Malaysia., Rajagopal R; Department of Paediatrics, University of Malaya, Kuala Lumpur, Malaysia.; Paediatric Haematology-Oncology and Bone Marrow Transplantation Unit, University of Malaya Medical Centre, Kuala Lumpur, Malaysia., Lum SH; Paediatric Haematology-Oncology and Bone Marrow Transplantation Unit, University of Malaya Medical Centre, Kuala Lumpur, Malaysia., Chan LL; Subang Jaya Medical Centre, Subang Jaya, Malaysia., Lin HP; Subang Jaya Medical Centre, Subang Jaya, Malaysia.
Jazyk: angličtina
Zdroj: Journal of paediatrics and child health [J Paediatr Child Health] 2020 Mar; Vol. 56 (3), pp. 379-383. Date of Electronic Publication: 2019 Sep 03.
DOI: 10.1111/jpc.14621
Abstrakt: Aim: Inborn errors of immunity (IEI) comprise a heterogeneous group of disorders of the immune system, most of which are curable by haematopoietic stem cell transplantation (HSCT). We present a 25-year audit of HSCT for IEI at a tertiary-level academic hospital in Malaysia.
Methods: Review of medical records of all cases of IEI who underwent HSCT between January 1993 and December 2018 at our centre. Diagnoses, complications, HSCT protocols and outcome data were studied.
Results: There were 20 patients (19 boys) with a median age at diagnosis of 11 months (range: 2 months to 12 years). Eleven of 19 (58%) had malnutrition at presentation. Donor sources were variable: 13 (65%) matched sibling donor (MSD), 4 (20%) human leukocyte antigen-haploidentical donor (HD) and 3 (15%) matched unrelated donor (MUD). Conditioning regimens were physician-dependent and adapted to each patient's clinical status. Grades III-IV acute graft-versus-host disease occurred in two of three cases who received MUD grafts, 50% in those who received HD, and 8% in the MSD group. Transplant-related mortality at day +100 was 5%. With a median follow-up of 7.5 years, 18 (90%) patients are alive and free of infections.
Conclusion: Outcome of HSCT for IEI in our centre is comparable with international reports. HSCT results using HD and MUD grafts are also good despite challenges from acute graft-versus-host disease, providing a feasible alternative for patients without matched donors.
(© 2019 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).)
Databáze: MEDLINE
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