Allogeneic stem cell transplantation with reduced intensity conditioning for patients with adrenoleukodystrophy

Koji Kato, Ryo Maemura, Manabu Wakamatsu, Ayako Yamamori, Motoharu Hamada, Shinsuke Kataoka, Atsushi Narita, Shunsuke Miwata, Yuko Sekiya, Nozomu Kawashima, Kyogo Suzuki, Kotaro Narita, Sayoko Doisaki, Hideki Muramatsu, Hirotoshi Sakaguchi, Kimikazu Matsumoto, Yuka Koike, Osamu Onodera, Makiko Kaga, Nobuyuki ShimozawaNao Yoshida

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objective: The prognosis of adrenoleukodystrophy (ALD)with neurological involvement is generally dismal; however, allogeneic stem cell transplantation (SCT) is recognized as effective to stabilize or improve the clinical symptoms of ALD. Herein, we report the clinical outcomes of patients with ALD who consecutively underwent allogeneic stem cell transplantation with reduced intensity conditioning at our institution. Patients: Sixteen patients with ALD, who were symptomatic (n = 14) or presymptomatic (n = 2), received SCT from 2010 to 2016. The stem cell source was cord blood (n = 14), or bone marrow from a human leukocyte antigen identical sibling (n = 2). The conditioning regimen prior to transplantation was reduced intensity and consisted of fludarabine (125 mg/m2), melphalan (140 mg/m2) and low dose total body irradiation (TBI) of 4Gy (n = 15) or 3Gy (n = 1). Results: Primary engraftment was obtained in 11 patients, and 4 of the 5 patients who lost the primary graft received a second cord blood transplantation and were engrafted. Five years overall and event-free survival were 90.9% and 61.1% respectively, with a median of 45 months (range 16–91). Loes score stabilized or improved by 18 months after transplantation except for patients with internal capsule involvement. Conclusion: Allogeneic SCT with reduced intensity conditioning for patients with ALD was safely performed without major transplant-related complications even in symptomatic patients and neurological symptoms were stabilized after SCT in patients without internal capsule involvement.

Original languageEnglish
Pages (from-to)1-6
Number of pages6
JournalMolecular Genetics and Metabolism Reports
Volume18
DOIs
Publication statusPublished - Mar 2019
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Molecular Biology
  • Genetics
  • Endocrinology

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    Kato, K., Maemura, R., Wakamatsu, M., Yamamori, A., Hamada, M., Kataoka, S., Narita, A., Miwata, S., Sekiya, Y., Kawashima, N., Suzuki, K., Narita, K., Doisaki, S., Muramatsu, H., Sakaguchi, H., Matsumoto, K., Koike, Y., Onodera, O., Kaga, M., ... Yoshida, N. (2019). Allogeneic stem cell transplantation with reduced intensity conditioning for patients with adrenoleukodystrophy. Molecular Genetics and Metabolism Reports, 18, 1-6. https://doi.org/10.1016/j.ymgmr.2018.11.001