RAPID DETECTION OF ENGRAFTMENT USING T-CELL RECEPTOR GENE POLYMORPHISM AFTER ALLOGENEIC BONE-MARROW TRANSPLANTATION IN AN ALLOIMMUNIZED CHILD WITH SEVERE APLASTIC-ANEMIA

A severely alloimmunized boy with aplastic anemia received an HLA-iden tical BMT from his brother. Despite intensive immunosuppression and la rge marrow dose, peripheral signs of engraftment occurred only late un der G-CSF treatment. With leukocyte counts of < 0.5 x 10(9)/1, chimeri sm could be proven not only by oligonucleotide fingerprinting but also within 48 h by analysis of polymorphism in the TCR gene family. This rapid and sensitive method to detect engraftment before it became quan titatively evident was important for the clinical management of the pa tient, obviating the need to search for an alternative marrow donor.