Sustained and full fetal hemoglobin production after failure of bone marrow transplant in a patient homozygous for beta 0‐thalassemia: A clinical remission despite genetic disease and transplant rejection

An adult patient affected by β 0 ‐thalassemia major underwent allogeneic bone marrow transplant (BMT) from a matched related donor. Forty days after transplant, allogeneic engraftment failure and autologous β 0 ‐thalassemic bone marrow recovery were documented. Red blood cell transfusions were required until 118 days post‐transplant. Thereafter, the haemoglobin (Hb) levels stabilized over 11.8 gr/dl throughout the ongoing 34‐month follow‐up, abolishing the need for transfusion support. The Hb electrophoresis showed 100% Hb Fetal (HbF). This unexplained case suggests full HbF production may occur in an adult patient with β 0 ‐thalassemia major. Am. J. Hematol. 2009. © 2009 Wiley‐Liss, Inc.