HLA-haploidentical blood progenitor cell transplantation in osteopetrosis

Blood. 2002 May 1;99(9):3458-60. doi: 10.1182/blood.v99.9.3458.

Abstract

Infantile osteopetrosis (OP) carries an extremely poor prognosis unless treated early by hematopoietic stem cell transplantation. We explored the use of purified blood progenitor cells from HLA-haploidentical parents in 7 patients lacking suitable matched donors. Blood progenitor cells were purified by positive selection and by additional T-cell depletion using rosette formation. For conditioning, patients received busulfan, thiotepa, and either cyclophosphamide (5 patients) or fludarabine (2 patients). Stable donor engraftment developed in 6 of 7 patients. Graft-versus-host disease was not observed. Three of the 7 patients had no major complications and 4 of 7 had both veno-occlusive disease and respiratory failure. Five of 7 patients survive with complete cure of OP at a median of 4 years. Patients with OP lacking HLA-matched donors can be successfully treated by transplantation of purified blood progenitor cells from HLA-haploidentical donors.

MeSH terms

  • Blood Cells / transplantation
  • Disease-Free Survival
  • Family Health
  • Female
  • Haplotypes
  • Hematopoietic Stem Cell Transplantation / adverse effects
  • Hematopoietic Stem Cell Transplantation / methods*
  • Histocompatibility Testing*
  • Humans
  • Infant
  • Infant, Newborn
  • Lymphocyte Depletion
  • Male
  • Osteopetrosis / complications
  • Osteopetrosis / congenital
  • Osteopetrosis / therapy*
  • Transplantation Conditioning / adverse effects
  • Treatment Outcome