RECOMBINANT HUMAN G-CSF-MOBILIZED PERIPHERAL-BLOOD STEM-CELLS FOR 2NDALLOGENEIC TRANSPLANT AFTER BONE-MARROW GRAFT-REJECTION IN CHILDREN

Two children affected by severe aplastic anaemia and sickle cell anaem ia rejected the allogeneic bone marrow transplantation from an HLA-mat ched unrelated volunteer and an HLA-identical sibling, respectively. I n both cases a second transplant using granulocyte-colony stimulating factor (G-CSF) mobilized peripheral blood stem cells (PBSC) was perfor med. Donors were the HLA-haploidentical mother and the same HLA-identi cal sibling who was employed for the first marrow allograft, respectiv ely. Treatment with G-CSF and PBSC collection were well tolerated. Bot h patients had engraftment of donor haemopoiesis and did not experienc e severe graft-versus-host disease. These cases confirm that PBSC tran splant should be considered as a feasible treatment to reverse graft f ailure in paediatric patients.