期刊
JOURNAL OF CLINICAL IMMUNOLOGY
卷 37, 期 1, 页码 85-91出版社
SPRINGER/PLENUM PUBLISHERS
DOI: 10.1007/s10875-016-0348-4
关键词
Hematopoietic stem cell transplantation; hemophagocytic lymphohistiocytosis; inflammatory bowel disease; reduced intensity conditioning; XIAP deficiency; X-linked lymphoproliferative syndrome
类别
资金
- Ministry of Education, Culture, Sports, Science, and Technology of Japan
- Ministry of Health, Labour, and Welfare of Japan
- Grants-in-Aid for Scientific Research [26461570] Funding Source: KAKEN
X-linked inhibitor of apoptosis protein (XIAP) deficiency is a rare immunodeficiency that is characterized by recurrent hemophagocytic lymphohistiocytosis (HLH) and splenomegaly and sometimes associated with refractory inflammatory bowel disease (IBD). Although hematopoietic stem cell transplantation (HSCT) is the only curative therapy, the outcomes of HSCT for XIAP deficiency remain unsatisfactory compared with those for SLAM-associated protein deficiency and familial HLH. To investigate the outcomes and adverse events of HSCT for patients with XIAP deficiency, a national survey was conducted. A spreadsheet questionnaire was sent to physicians who had provided HSCT treatment for patients with XIAP deficiency in Japan. Up to the end of September 2016, 10 patients with XIAP deficiency had undergone HSCT in Japan, 9 of whom (90%) had survived. All surviving patients had received a fludarabine-based reduced intensity conditioning (RIC) regimen. Although 5 patients developed post-HSCT HLH, 4 of them survived after etoposide administration. In addition, the IBD associated with XIAP deficiency improved remarkably after HSCT in all affected cases. The RIC regimen and HLH control might be important factors for successful HSCT outcomes, with improved IBD, in patients with XIAP deficiency.
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