Chronic graft-versus-host disease with multiple serositis after bone marrow transplantation from non-inherited maternal antigen-complementary sibling donor

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  • AKAHANE Koshi
    Department of Pediatrics, Faculty of Medicine, University of Yamanashi
  • INUKAI Takeshi
    Department of Pediatrics, Faculty of Medicine, University of Yamanashi
  • NEMOTO Atsushi
    Department of Pediatrics, Faculty of Medicine, University of Yamanashi
  • KURODA Itaru
    Department of Pediatrics, Faculty of Medicine, University of Yamanashi
  • MINAI Amane
    Department of Pediatrics, Faculty of Medicine, University of Yamanashi
  • HIROSE Kinuko
    Department of Pediatrics, Faculty of Medicine, University of Yamanashi
  • HONNA Hiroko
    Department of Pediatrics, Faculty of Medicine, University of Yamanashi
  • GOI Kumiko
    Department of Pediatrics, Faculty of Medicine, University of Yamanashi
  • SUGITA Kanji
    Department of Pediatrics, Faculty of Medicine, University of Yamanashi

Bibliographic Information

Other Title
  • NIMA相補的同胞からの骨髄移植後に多発性漿膜炎を呈した慢性GVHD
  • 症例報告 NIMA相補的同胞からの骨髄移植後に多発性漿膜炎を呈した慢性GVHD
  • ショウレイ ホウコク NIMA ソウホテキ ドウホウ カラ ノ コツズイ イショク ゴ ニ タハツセイショウマクエン オ テイシタ マンセイ GVHD

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Description

We report a patient who developed multiple serositis during chronic graft-versus-host disease (GVHD) after allogeneic bone marrow transplantation from a non-inherited maternal antigen (NIMA) -complementary sibling donor. The patient was a 9-year-old boy with myelodysplastic syndrome, who urgently underwent bone marrow transplantation from his NIMA-complementary HLA two-locus-mismatched sister following graft failure of cord blood transplantation. Engraftment was successfully confirmed and no acute GVHD developed. After withdrawal of tacrolimus to prevent recurrent viral infection, he developed pleural effusion, ascites and edema approximately 6 months after transplantation. His clinical symptoms were resolved by methylprednisolone pulse therapy, but he subsequently progressed to develop pericardial effusion, pneumothorax and truncal panniculitis. Pleural and pericardial effusion contained numerous lymphocytes, which gradually subsided with continuous drainage. His symptoms were thereafter controlled by the addition of mycophenolate mofetil (MMF) administration, and his current performance status is almost perfect by the administration of prednisolone (5 mg/day) and MMF at 6 years after transplantation. Although multiple serositis associated with GVHD is known to have a poor prognosis, the multiple symptoms of this patient improved gradually, probably owing to a lack of acute GVHD and the effect of MMF.

Journal

  • Rinsho Ketsueki

    Rinsho Ketsueki 51 (2), 132-137, 2010

    The Japanese Society of Hematology

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