期刊
BONE MARROW TRANSPLANTATION
卷 38, 期 1, 页码 17-21出版社
NATURE PUBLISHING GROUP
DOI: 10.1038/sj.bmt.1705401
关键词
mucopolysaccharidosis type 1; alpha-L-iduronidase; enzyme replacement therapy; haematopoietic cell transplantation
Hurler syndrome ( MPS 1H) is the severe form of mucopolysaccharidosis type 1 ( MPS 1). Haematopoietic cell transplantation ( HCT) is the treatment of choice, but carries a high incidence of graft failure and morbidity. The use of enzyme replacement therapy ( ERT) might improve the clinical signs and symptoms before HCT, resulting in less transplantation-related complications. Moreover, clearance of glycosaminoglycans ( GAG's) from the bone marrow might improve engraftment. Twenty-two patients with MPS 1H received one or more HCT procedures in combination with ERT. One patient with severe cardiomyopathy improved significantly after ERT. All children were in a relatively good clinical condition before HCT. Of patients 59, 82 and 86% were alive and engrafted after one, two and three HCT procedures, respectively. Two patients died after repetitive HCT. No serious ERT-infusion related toxicity occurred. ERT with HCT was well tolerated. Neither a positive nor a negative effect on the number of patients who are alive and engrafted after receiving ERT before HCT as compared to a historic cohort was noted. However, patients in a poor clinical condition before HCT might benefit from ERT.
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