Booster transplantation for a MDS patient to improve poor graft function after allogeneic transplantation

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  • Hatsuse Mayumi
    Department of Hematology, Japan Community Health care Organization, Kyoto Kuramaguchi Medical Center
  • Fuchida Shin-ichi
    Department of Hematology, Japan Community Health care Organization, Kyoto Kuramaguchi Medical Center
  • Okano Akira
    Department of Hematology, Japan Community Health care Organization, Kyoto Kuramaguchi Medical Center
  • Murakami Satoshi
    Department of Hematology, Japan Community Health care Organization, Kyoto Kuramaguchi Medical Center
  • Shimazaki Chihiro
    Department of Hematology, Japan Community Health care Organization, Kyoto Kuramaguchi Medical Center

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  • 同種移植後のドナー型造血不全に対して同一ドナーよりブースター移植を実施した骨髄異形成症候群

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 A 29-year-old male with myelodysplastic syndrome (RAEB-1) underwent allogeneic peripheral blood stem cell transplantation from his father whose HLA-DR was serologically mismatched at the DR locus. Neutrophils>500/μL and platelets>20,000/μL were achieved on day 17 and day 25 respectively, but two months after transplantation, pancytopenia was progressed associated with cytomegalovirus antigenemia. Chimerism analysis showed complete donor type, but six month later he was dependent on RBC transfusion. He was diagnosed as poor graft function. Booster transplantation of bone marrow from the same donor was performed without pre-conditioning therapy nine months after transplantation, hematopoietic recovery was rapid with no aggravation of graft versus host disease and then immunosuppressant was tapered. These observations suggest that booster transplantation of bone marrow including mesenchymal stem cells might contribute to be improvement of bone marrow microenviroment, which led to hematopoietic recovery in a patient with poor graft function.

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