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Donor T-cell–mediated Pancytopenia After Haploidentical Hematopoietic Stem Cell Transplant For Severe Combined Immunodeficiency

Norris, Robin MD; Paessler, Michele MD; Bunin, Nancy MD

Journal of Pediatric Hematology/Oncology: February 2009 - Volume 31 - Issue 2 - p 148-150
doi: 10.1097/MPH.0b013e3181979c4a
Clinical and Laboratory Observations

Haploidentical hematopoietic stem cell transplant with T-cell depletion may result in donor T-cell engraftment in infants with severe combined immunodeficiency disease. Engraftment of other hematopoietic lines is achieved rarely, and pancytopenia and hemophagocytosis as a result of donor T-cell engraftment have not been reported. We report an infant with severe combined immunodeficiency who developed graft versus host disease with pancytopenia as a result of engraftment of maternal T cells after T-depleted hematopoietic stem cell transplant. His pancytopenia resolved after thymoglobulin and a stem cell boost. Thrombocytopenia resolved with rituximab.

Departments of *Pediatrics

Pathology, The Children's Hospital of Philadelphia, Philadelphia, PA

Reprints: Nancy Bunin, MD, Division of Oncology, The Children's Hospital of Philadelphia, 34th and Civic Center Boulevard, Philadelphia, PA 19104 (e-mail:

Received for publication May 1, 2008; accepted November 11, 2008

© 2009 Lippincott Williams & Wilkins, Inc.