DETECTION OF DONOR LYMPHOCYTES IN THE CEREBROSPINAL-FLUID OF A PATIENT WITH METACHROMATIC LEUKODYSTROPHY FOLLOWING BONE-MARROW TRANSPLANTATION

An unrelated donor bone marrow transplant (UD-BMT) was carried out on a 10-year-old patient with metachromatic leukodystrophy (MLD). We coll ected cerebrospinal fluid (CSF) on day +168 and cultured it with recom binant IL-2 and PHA-P to examine the origin of cells in the CSF. Analy sis on variable number of tandem repeat (VNTR) of lymphocytes in the C SF amplified by PCR revealed that lymphocytes in the CSF were of donor origin, These data support that BMT at an early stage may prevent det erioration in MLD. Although the patient developed grade III acute GVHD with rash and diarrhea, we successfully treated acute GVHD using rabb it anti-human thymocyte immunoglobulin (ATG), UD-BMT may be an alterna tive treatment for patients with MLD in the absence of an HLA matched family donor.