Domino donor lymphocyte infusion for secondary poor graft function after
HLA-mismatched allogeneic stem cell transplantation between
HLA-identical sibling pairs with congenital immunodeficiency
Abstract
Poor graft function (PGF) is a major obstacle to successful allogeneic
stem cell transplantation after achieving normal bone marrow function.
We report a successful treatment of domino DLI for poor graft function
in younger brother with hyper IgM syndrome from HLA-identical elder
brother with the same disorder with a history of HLA-mismatched
unrelated bone marrow transplantation using same donor. Immunological
profiling revealed that DLI-induced T-regulatory cells could correct
skewed immune responses in the BM microenvironment due to secondary PGF
pathogenesis. Immunological tolerized domino DLI can be a new
therapeutic option for secondary PGF in HLA-identical sibling pairs with
congenital immunodeficiency.