Chemotherapy for a secondary malignancy nearly restores complete chimerism in an SCID-patient after HSCT

For patients with inborn errors of immunity (IEI) and other inborn diseases, mixed donor chimerism is a well-accepted outcome of hematopoietic stem cell transplantation (HSCT). Cytoreductive chemotherapy for a secondary malignancy is a potential challenge for the stability of the graft function afte...

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Published in:Clinical immunology (Orlando, Fla.) Fla.), 2024-02, Vol.259, p.109891-109891, Article 109891
Main Authors: Maier, Felix I, Schulz, Ansgar, Furlan, Ingrid, Felgentreff, Kerstin, Jacobsen, Eva-Maria, Sirin, Mehtap, Schwarz, Klaus, Pannicke, Ulrich, Stursberg, Jana, Debatin, Klaus-Michael, Hönig, Manfred
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Language:English
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Summary:For patients with inborn errors of immunity (IEI) and other inborn diseases, mixed donor chimerism is a well-accepted outcome of hematopoietic stem cell transplantation (HSCT). Cytoreductive chemotherapy for a secondary malignancy is a potential challenge for the stability of the graft function after HSCT. We report on a boy with X-SCID who developed Ewing sarcoma ten years after HSCT which was successfully treated with cytoreductive chemotherapy, surgery and local radiation. Surprisingly, this treatment had a positive impact on mixed chimerism with an increase of donor-cell proportions from 40% for neutrophils and 75% for non-T-mononuclear cells (MNCs) to >90% for both. T-cell counts remained stable with 100% of donor origin. This is -to our knowledge- the first report on the impact of cytoreductive chemotherapy on post-HSCT mixed chimerism and provides an important first impression for future patients.
ISSN:1521-6616
1521-7035
DOI:10.1016/j.clim.2024.109891