論文

査読有り
2017年9月21日

Hematopoietic stem cell transplantation in 29 patients hemizygous for hypomorphic IKBKG/NEMO mutations

Blood
  • Charline Miot
  • Kohsuke Imai
  • Chihaya Imai
  • Anthony J. Mancini
  • Zeynep Yesim Kucuk
  • Tokomki Kawai
  • Ryuta Nishikomori
  • Etsuro Ito
  • Isabelle Pellier
  • Sophie Dupuis Girod
  • Jeremie Rosain
  • Shinya Sasaki
  • Shanmuganathan Chandrakasan
  • Jana Pachlopnik Schmid
  • Tsubasa Okano
  • Estelle Colin
  • Alberto Olaya-Vargas
  • Marco Yamazaki-Nakashimada
  • Waseem Qasim
  • Sara Espinosa Padilla
  • Andrea Jones
  • Alfons Krol
  • Nyree Cole
  • Stephen Jolles
  • Jack Bleesing
  • Thomas Vraetz
  • Andrew R. Gennery
  • Mario Abinun
  • Tayfun Güngör
  • Beatriz Costa-Carvalho
  • Antonio Condino-Neto
  • Paul Veys
  • Steven M. Holland
  • Gulbu Uzel
  • Despina Moshous
  • Benedicte Neven
  • Stéphane Blanche
  • Stephan Ehl
  • Rainer Döffinger
  • Smita Y. Patel
  • Anne Puel
  • Jacinta Bustamante
  • Erwin W. Gelfand
  • Jean-Laurent Casanova
  • Jordan S. Orange
  • Capucine Picard
  • 全て表示

130
12
開始ページ
1456
終了ページ
1467
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1182/blood-2017-03-771600
出版者・発行元
American Society of Hematology

X-linked recessive ectodermal dysplasia with immunodeficiency is a rare primary immunodeficiency caused by hypomorphic mutations of the IKBKG gene encoding the nuclear factor κB essential modulator (NEMO) protein. This condition displays enormous allelic, immunological, and clinical heterogeneity, and therapeutic decisions are difficult because NEMO operates in both hematopoietic and nonhematopoietic cells. Hematopoietic stem cell transplantation (HSCT) is potentially life-saving, but the small number of case reports available suggests it has been reserved for only the most severe cases. Here, we report the health status before HSCT, transplantation outcome, and clinical follow-up for a series of 29 patients from unrelated kindreds from 11 countries. Between them, these patients carry 23 different hypomorphic IKBKG mutations. HSCT was performed from HLA-identical related donors (n = 7), HLA-matched unrelated donors (n = 12), HLA-mismatched unrelated donors (n = 8), and HLA-haploidentical related donors (n = 2). Engraftment was documented in 24 patients, and graft-versus-host disease in 13 patients. Up to 7 patients died 0.2 to 12 months after HSCT. The global survival rate after HSCT among NEMO-deficient children was 74% at a median follow-up after HSCT of 57 months (range, 4-108 months). Preexisting mycobacterial infection and colitis were associated with poor HSCT outcome. The underlying mutation does not appear to have any influence, as patients with the same mutation had different outcomes. Transplantation did not appear to cure colitis, possibly as a result of cell-intrinsic disorders of the epithelial barrier. Overall, HSCT can cure most clinical features of patients with a variety of IKBKG mutations.

リンク情報
DOI
https://doi.org/10.1182/blood-2017-03-771600
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/28679735
ID情報
  • DOI : 10.1182/blood-2017-03-771600
  • ISSN : 1528-0020
  • ISSN : 0006-4971
  • PubMed ID : 28679735
  • SCOPUS ID : 85029784195

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