[CIS-PAGID] T - B - conditioning

[Cowan, Mort]

The use of conditioning is really going to depend on the type of donor you have and whether or not there is radiation sensitivity. Have you looked for maternal engraftment? If positive, you could use the Mom as the donor with T cell depletion without any conditioning. That would be best given the infections. If you could find an 8/8 allele matched unrelated donor, that also might work without conditioning; you might not get B cell reconstitution but right now the child needs working T cells I would think in order to clear the CMV infection.

Mort

Morton J. Cowan, M.D.
Professor of Pediatrics
Chief, Allergy, Immunology, and Blood and Marrow Transplant 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 Nacho Gonzalez
Sent: Thursday, May 17, 2012 1:50 AM
To: pagid at list.clinimmsoc.org
Subject: [CIS-PAGID] T - B - conditioning

Dear all,

I have a SCID patient (three month old female) T-B-NK + [Total lymph 590/uL, CD4+CD45RA+ 4/uL, CD4+CD45RA+CD31+ 5% (normal above 44%) , CD19 2 /uL, CD3+56- 466 /uL]   with rotavirus and CMV infection -with hemorrhagic enterocolitis. However her clinical condition is stable- (CMV viral load 122.000 copies/ml, on ganciclovir treatment -viral load under treatment pending- )
RAG1/2 genes: normal.
Artemis & ADA: pending, but no bird-like face, no bone abnormalities, normal uric acid and normal neurological examination). FOCI assay is pending

There isn´t identical familial donor.  Search for a non-familial donor: pending

I would like to know which ideal conditioning regimen do you suggest for this patient

Any other thoughts? Any input would be welcomed.

Thanks in advance for your time.

Luis Ignacio Gonzalez Granado
Immunodeficiencies Unit
Hospital 12 octubre. Madrid. Spain

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