[PAGID] transplant question

[Cowan, Mort]

Chris,

 

How good was the cord blood match; I'm assuming unrelated and was the
typing by high resolution? What kind of conditioning was used? This
could certainly be rejection. If GvHD, the CD8's are often predominant
and skin biopsy should help.

 

Mort

 

Morton J. Cowan, M.D.

Professor of Pediatrics

Chief, BMT Division

UCSF Children's Hospital, Room M659

505 Parnassus Ave

San Francisco, CA 94143-1278

phone: 415-476-2188 
fax: 415-502-4867 

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________________________________

From: pagid-bounces at list.clinimmsoc.org
[mailto:pagid-bounces at list.clinimmsoc.org] On Behalf Of Christine
Seroogy
Sent: Monday, May 07, 2007 7:22 AM
To: pagid at list.clinimmsoc.org
Subject: [PAGID] transplant question

 

I am involved with a SCID patient (confirmed Rag 2 mutation) who is D+90
from matched cord blood transplant who has had a considerable change in
her peripheral blood lymphocyte population.  She is currently on
prednisone and CsA for GVH prophylaxis and was doing well until about 10
days ago when she developed a pruritic total body skin rash (similar to
her OS rash prior to transplant.)  Her flow demonstrated significant
loss of CD3+ cells over the past month (abs. CD3+CD4+ 140 and month
before 440--meds have not changed) and expansion of NK cells
(CD2+CD56+CD3-CD16-, absolute 556 and represents 81% of peripheral blood
lymphocytes).  STR one month ago on CD3+ cells was 86% donor.  I am
concerned about this change, but am uncertain if it is related to her
clinical picture and how to further pursue it.  Our transplant team is
primarily managing her.  We intend to obtain a skin biopsy, but
management probably won't change based on this.  I am wondering if
others have seen this in the post-transplant setting or have additional
recommendations?  Many thanks, Chris

 

 

 

Chris Seroogy, M.D.

Assistant Professor

Dept. of Pediatrics

Mail:  H4/474 CSC, Mailstop 4108

Shipping:  H4/431 CSC, Mailstop 4108

600 Highland Ave.

Madison, WI  53792

phone: 608- 263-2652

fax: 608-265-0164

 

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