Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 6, 2019; 7(21): 3622-3631
Published online Nov 6, 2019. doi: 10.12998/wjcc.v7.i21.3622
Child with Wiskott–Aldrich syndrome underwent atypical immune reconstruction after umbilical cord blood transplantation: A case report
Bo-Han Li, Shao-Yan Hu
Bo-Han Li, Shao-Yan Hu, Department of Hematology and Oncology, Children’s Hospital of Soochow University, Suzhou 215000, Jiangsu Province, China
Author contributions: Li BH and Hu SY wrote and edited the final manuscript; both authors have read and approved the final manuscript.
Supported by National Natural Science Foundation of China, No. 81770193.
Informed consent statement: Written informed consent was obtained from the patient’s legal guardian(s) for publication of this case report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest in relation to this manuscript.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Shao-Yan Hu, PhD, Chief Doctor, Department of Hematology and Oncology, Children’s Hospital of Soochow University, 92 Zhongnan Street, Suzhou 215000, Jiangsu Province, China. hsy139@126.com
Telephone: +86-512-80692929
Received: April 17, 2019
Peer-review started: April 18, 2019
First decision: June 12, 2019
Revised: June 21, 2019
Accepted: July 20, 2019
Article in press: July 20, 2019
Published online: November 6, 2019
Processing time: 206 Days and 0.2 Hours
Abstract
BACKGROUND

Timely reconstitution of a donor-derived immune system is important for recovery and long-term survival of patients after allogeneic hematopoietic stem cell transplantation (HSCT). We describe a case of Wiskott–Aldrich syndrome (WAS) treated by umbilical cord blood transplantation (UCBT) with atypical immune reconstruction.

CASE SUMMARY

A 1-year-old Chinese male infant was diagnosed with WAS. WAS gene sequencing identified the mutation c.777 + 1G>A (IVS8). On August 8, 2017, he was admitted to our hospital for HSCT. We selected an unrelated Human leukocyte antigen 6/10-matched donor for UCBT. After HSCT, the immune reconstitution process was atypical, the lymphocytes reached 0.5 × 109/L on day 23, and the neutrophils reached 0.5 × 109/L on day 34. The patient’s recovery throughout the year was good.

CONCLUSION

An increase in lymphocytes (especially T cells) earlier than granulocytes may be a marker of a good prognosis in UCBT.

Keywords: Umbilical cord blood transplantation; Wiskott–Aldrich syndrome; Immune reconstruction; Case report

Core tip: The timely reconstitution of a donor-derived immune system is of utmost importance for the recovery and long-term survival of patients after hematopoietic stem cell transplantation. Here, we describe a case of Wiskott–Aldrich syndrome treated by umbilical cord blood transplantation with the atypical process of immune reconstitution. Our case revealed that an increase in the number of lymphocytes (especially T cells) earlier than granulocytes may be a marker of a good prognosis in patients. This experience will guide clinical scientists, especially hematologists, to deal with similar situations and encourage them to identify more processes that require immune reconstruction.