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Haematopoietic stem cell transplantation for inborn errors of immunity: 25‐year experience from University of Malaya Medical Centre, Malaysia
Author(s) -
Ariffin Hany,
Ab Rahman Syaza,
Jawin Vida,
Foo Jen Chun,
Amram Nur Faizana,
Mahmood Nur Mahirah,
Yap Tsiao Yi,
Rajagopal Revathi,
Lum Su Han,
Chan Lee Lee,
Lin Hai Peng
Publication year - 2020
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/jpc.14621
Subject(s) - medicine , transplantation , medical record , pediatrics , hematopoietic stem cell transplantation , disease , surgery
Aim Inborn errors of immunity (IEI) comprise a heterogeneous group of disorders of the immune system, most of which are curable by haematopoietic stem cell transplantation (HSCT). We present a 25‐year audit of HSCT for IEI at a tertiary‐level academic hospital in Malaysia. Methods Review of medical records of all cases of IEI who underwent HSCT between January 1993 and December 2018 at our centre. Diagnoses, complications, HSCT protocols and outcome data were studied. Results There were 20 patients (19 boys) with a median age at diagnosis of 11 months (range: 2 months to 12 years). Eleven of 19 (58%) had malnutrition at presentation. Donor sources were variable: 13 (65%) matched sibling donor (MSD), 4 (20%) human leukocyte antigen‐haploidentical donor (HD) and 3 (15%) matched unrelated donor (MUD). Conditioning regimens were physician‐dependent and adapted to each patient's clinical status. Grades III–IV acute graft‐versus‐host disease occurred in two of three cases who received MUD grafts, 50% in those who received HD, and 8% in the MSD group. Transplant‐related mortality at day +100 was 5%. With a median follow‐up of 7.5 years, 18 (90%) patients are alive and free of infections. Conclusion Outcome of HSCT for IEI in our centre is comparable with international reports. HSCT results using HD and MUD grafts are also good despite challenges from acute graft‐versus‐host disease, providing a feasible alternative for patients without matched donors.