同種骨髄移植後の造血不全に対し同種末梢血幹細胞移植をした1例

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  • Allogeneic Peripheral Blood Stem-Cell Transfusion for a Case of Incomplete Engraftment after Allogeneic Bone Marrow Transplantation.

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We report the case of a 16-year-old boy with acute lymphoblastic leukemia who had bone marrow relapse. He received a minor bone marrow transplantation from his HLA-matched brother. Hematopoietic cell amelioration after the bone marrow transplantation was delayed. We administered erythropoietin (12, 000 units/week) beginning 120 days after the bone marrow transplantation, but the anemia did not improve. The boy had hepatic GVHD 120 days after the bone marrow transfusion, but symptoms were reduced by cyclosporin A administration. Erythrocyte blood transfusion and platelet transfusion were required for more than 200 days after the bone marrow transfusion. Because the hypoplasia of erythroblasts and megakaryocytes persisted as a consequence of his marrow examination, we undertook a peripheral blood stem-cell transfusion from the brother. The stem-cell harvests were collected continuously for 2 days after continuous subcutaneous injection of G-CSF (6 μg/kg) every 12 hr for 5 days. The final platelet transfusion was 15 days after the PBSCT, and the final erythrocyte blood transfusion was 18 days after. Acute GVHD appeared in the skin and liver, but there was recovery after the loading of cyclosporin A. The patient is presently in complete remission without problems of hematogenesis ability after PBSCT.

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