Disparate lympho‐erythroid donor to recipient chimaerism in a β°‐thalassaemia bone marrow transplant recipient with red cell indices indicative of apparent full engraftment

• Published in: British journal of haematology Vol. 99; no. 1; pp. 61 - 63
• Main Authors: Weinberg, R. S., Vlachos, A., Najfeld, V., Galperin, Y., Scalise, A., Fruchtman, S., Lipton, J. M.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01.10.1997; Blackwell
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; beta-Thalassemia - genetics; beta-Thalassemia - therapy; BFU‐E; Biological and medical sciences; bone marrow transplantation; Bone Marrow Transplantation - methods; Bone Marrow Transplantation - pathology; Bone marrow, stem cells transplantation. Graft versus host reaction; Child, Preschool; chimaerism; Erythrocyte Count; Erythroid Precursor Cells - pathology; Female; Humans; Karyotyping; Lymphocytes - pathology; Medical sciences; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Transplantation Chimera; β°‐thalassaemia; β‐globin; Human; Erythropoiesis; Hemoglobinopathy; HLA-System; Leukopoiesis; Lymphopoiesis; Transfusion; Major histocompatibility system; Related donor; Homograft; Hemopathy; Genetic disease; Case study; Hemolytic anemia; Treatment; β-Thalassemia; Hematopoiesis; Bone marrow; Engraftment; Graft; Chimerism; Child; Histocompatibility
• ISSN: 0007-1048; 1365-2141
• DOI: 10.1046/j.1365-2141.1997.3413154.x

A 4‐year‐old girl with transfusion‐dependent β°‐thalassaemia received an HLA‐identical bone marrow transplant (BMT) from her β°‐thalassaemia trait sister. Prior to BMT, chromosomal analysis revealed the recipient to have 46,XX,9qh+, a polymorphic variant of the heterochromatin region of chromosome 9, which her donor did not have. Within 1 month post‐BMT, 89% of nucleated bone marrow cells were of donor origin. One year later, donor engraftment had decreased to 44% and 34% in nucleated bone marrow cells and blood lymphocytes, respectively. By 2 years, donor lymphocyte engraftment fell to 5%, raising concern of possible graft rejection. To examine erythroid chimaerism, globin synthesis by individual erythroid progenitor cell derived colonies (BFU‐E) was analysed. On days 1000 and 1130 post‐BMT, 79% and 77% of colonies, respectively, synthesized β‐globin and therefore were of donor origin.