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Graft-Versus-Host Disease

Severe acute graft-versus-host disease after T-cell depleted allogeneic stem cell graft from a second donor caused by persisting T-cells from the first donor

Bone Marrow Transplantation volume 32, pages 511–513 (2003)Cite this article

Summary:

HLA disparity is a major risk factor for graft rejection and GVHD. We report a patient with CML (accelerated phase) who underwent allogeneic SCT from a mismatched unrelated donor and developed acute GVHD. With immunosuppression, GVHD symptoms improved but graft rejection occurred. After a second conditioning regimen, the patient received a second graft from a haploidentical related donor. Engraftment occurred, but the patient died from GVHD and pulmonary aspergillosis. Chimeric analysis revealed that all leukocytes were of donor 2 origin apart from CD3+ T cells, which were 100% donor 1 type. Thus, in spite of intensified immunosuppression and successful transplantation of a second graft, T cells from the first donor persisted and induced severe acute GVHD.

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Authors and Affiliations

  1. Department of Haematology, Oncology, Immunology and Rheumatology,

    A Wiesmann, C Faul, L Kanz & H Einsele

  2. Division of Medicine, University of Tübingen, Tübingen, Germany

    A Wiesmann, C Faul, L Kanz & H Einsele

  3. Paediatric Haematology,

    P Bader

  4. University of Tübingen, Tübingen, Germany

    P Bader

  5. Department of Radiooncology, University of Tübingen, Tübingen, Germany

    M Bamberg

Authors
  1. A Wiesmann
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  2. P Bader
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  3. M Bamberg
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  4. C Faul
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  5. L Kanz
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  6. H Einsele
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Corresponding author

Correspondence to H Einsele.

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Wiesmann, A., Bader, P., Bamberg, M. et al. Severe acute graft-versus-host disease after T-cell depleted allogeneic stem cell graft from a second donor caused by persisting T-cells from the first donor. Bone Marrow Transplant 32, 511–513 (2003). https://doi.org/10.1038/sj.bmt.1704170

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  • DOI: https://doi.org/10.1038/sj.bmt.1704170

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