Patient and transplant characteristics
UPN . | Genetic type . | Sex . | Age at tx . | Pre-tx disease manifestations . | CNS+, Y/N . | Time from HLH diagnosis to tx, wk . | PR/CR at tx . | HLH criteria (Y/N)/HLH therapy (Y/N) . | Donor/HLA/source . | Serotherapy, total mg/kg bw . | CD34+/kg bw, ×106 . | Total Bu, dose, mg/kg bw . | Cum. Bu AUC, mg/L × h . | D until ANC >0.5 g/L . | D until PLT >50 g/L . |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1 | XLP1/SH2D1A | M | 16 y | Family history | N | NA | CR | N/IVIG | MUD/10/10/BM | Alemtuzumab 0.5 | 2.1 | 6.4 | 59 | 23 | 21 |
2 | XLP1/SH2D1A | M | 22 y | HLH episode, IgG low EBV-hepatitis/-CMP | N | 1040 | CR | Y/steroids | MSD/6/6/PBSC | Thymoglobulin 7.5 | 2.4 | 9.7 | 53 | 17 | 14 |
3 | XLP1/SH2D1A | M | 7 y | IgG low, DLBCL 2017 | N | N/A | CR | N/DLBCL chemotherapy | MUD/10/10/BM | Alemtuzumab 0.6 | 7.23 | 17 | 67 | 20 | 16 |
4 | XLP1/SH2D1A | M | 3.8 y | Developmental regression ADEM | Y | 14 | PR | N/IVIG, steroids, CY | MUD/9/10/BM | Alemtuzumab 0.6 | 15.3 | 26.4 | 54 | 24 | 74 |
5 | CHS/LYST | F | 1 y | Nystagmus, oculocutaneous albinism | N* | NA | CR | N/no treatment | MUD/10/10/BM | Alemtuzumab 0.5 | 2.7 | 12 | 64 | 23 | 38 |
6 | FHL5/STXBP2 | F | 3 mo | HLH episode, sepsis, mild renal impairment | N | 8 | PR | Y/HLH-2004, IVIG, alemtuzumab | MSD/6/6/BM | Alemtuzumab 0.5 | 13.4 | 14 | 53 | 17 | 38 |
7 | FHL5/STXBP2 | M | 8 mo | HLH episode, failure to thrive | N | 25 | CR | Y/HLH-2004, no CSA | MSD/6/6/BM | Thymoglobulin 7.5 | 7 | 10 | 66 | 14 | 47 |
8 | FHL5/STXBP2 | M | 4 mo | HLH episode, hepatic/renal failure | N | 15 | CR | Y/HLH-2004 | UCB/9/10/cord | Alemtuzumab 0.6 | 1.15 | 7.2 | 63 | 24 | 30 |
9 | FHL5/STXBP2 | F | 3 y | Recurrent HLH episodes | N | 20 | CR | Y/HLH-2004 | MUD/10/10/BM | Alemtuzumab 0.5 | 2.25 | 17.3 | 55 | 22 | 34 |
10 | FHL3/UNC13D | M | 10 mo | HLH episode, cardiac effusion | N | 11 | CR | Y/HLH-2004 | MUD/10/10/BM | Alemtuzumab 0.6 | 8.6 | 15.6 | 64 | 20 | 17 |
11 | FHL3/UNC13D | M | 5 mo | HLH episode, focal seizures, NEC | Y | 11 | CR | Y/HLH-2004 | MUD/10/10/BM | Alemtuzumab 0.5 | 5.58 | 16 | 77 | 19 | 42 |
12 | FHL3/UNC13D | M | 10 mo | HLH episode | N | 31 | CR | Y/steroids, CSA, alemtuzumab | MUD/10/10/PBSC | Alemtuzumab 0.6 | 10 | 16 | 65 | 28 | 14 |
13 | FHL3/UNC13D | F | 9.25 y | HLH episode, GBS | Y | 29 | PR | Y/HLH-2004 | MRD/10/10/BM | ATG-N 40 | 4.59 | 11.4 | 56 | 28 | 29 |
14 | FHL3/UNC13D | F | 4 mo | HLH episode, CMV+, CMP, neurologically handicapped | Y | 12 | PR | Y/steroids | UCB/10/10/cord | Thymoglobulin 7.5 | 0.9 | 12.08 | 48 | 21 | 28 |
15 | FHL3/UNC13D | M | 5 mo | HLH episode, FTT | Y | 20 | CR | Y/HLH-2004 | MSD/6/6/BM | Thymoglobulin 7.5 | 32.2 | 19.04 | 63 | 11 | 37 |
16 | FHL3/UNC13D | M | 7 mo | HLH episode, polyserositis | N | 23 | CR | Y/HLH-2004 | MUD/10/10/BM | Alemtuzumab 0.6 | 5.55 | 13.1 | 68 | 18 | 29 |
17 | FHL3/UNC13D | F | 3.5 y | HLH episode, thrombosis of the sinus sagittalis superior | Y | 19 | CR | Y/HLH-2004 | MUD/9/10/PBSC† | Alemtuzumab 0.6 | 13.95 | 12.4 | 62 | 15 | 11 |
18 | FHL3/UNC13D | F | 5 mo | HLH episode, FTT | N | 20 | CR | Y/HLH-2004, alemtuzumab | MUD/10/10/BM | Alemtuzumab 0.6 | 10.7 | 24.6 | 65 | 15 | 40 |
19 | FHL3/UNC13D | F | 5 mo | Family history | N | NA | CR | N/CSA | MUD/10/10/BM | Alemtuzumab 0.6 | 10 | 15.4 | 65 | 15 | 26 |
20 | FHL3/UNC13D | F | 2 mo | Family history | N | NA | CR | N/N | MSD/6/6/BM | Thymoglobulin 7.5 | 24.8 | 11.4 | 65 | 28 | 23 |
21 | FHL3/UNC13D | F | 3 mo | Recurrent HLH episodes | N | 15 | CR | Y/steroids, CSA, alemtuzumab | MUD/10/10 PBSC† | Alemtuzumab 0.6 | 25 | 11.8 | 62 | 20 | 13 |
22 | FHL3/UNC13D | M | 7 mo | HLH episode | N | 20 | CR | N/N | MSD/6/6/BM | Thymoglobulin 7.5 | 6.95 | 14.4 | 55 | 31 | 43 |
23 | FHL3/UNC13D | F | 4 mo | HLH episode | N | 10 | CR | Y/HLH-2004 | MUD/10/10/BM | Alemtuzumab 0.6 | 7.3 | 8 | 73 | 15 | 14 |
24 | Heterozygous UNC13D | M | 16 mo | Recurrent HLH episodes | N | 32 | CR | Y/steroids, CSA | MUD/10/10/PBSC | Alemtuzumab 0.6 | 11.3 | 17.2 | 59 | 20 | 12 |
25 | Unknown | F | 23 mo | Recurrent HLH episodes | Y | 62 | PR | Y/HLH-2004, infliximab | MUD/10/10/PBSC† | Alemtuzumab 0.8 | 15 | 11.1 | 65 | 18 | 24 |
UPN . | Genetic type . | Sex . | Age at tx . | Pre-tx disease manifestations . | CNS+, Y/N . | Time from HLH diagnosis to tx, wk . | PR/CR at tx . | HLH criteria (Y/N)/HLH therapy (Y/N) . | Donor/HLA/source . | Serotherapy, total mg/kg bw . | CD34+/kg bw, ×106 . | Total Bu, dose, mg/kg bw . | Cum. Bu AUC, mg/L × h . | D until ANC >0.5 g/L . | D until PLT >50 g/L . |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1 | XLP1/SH2D1A | M | 16 y | Family history | N | NA | CR | N/IVIG | MUD/10/10/BM | Alemtuzumab 0.5 | 2.1 | 6.4 | 59 | 23 | 21 |
2 | XLP1/SH2D1A | M | 22 y | HLH episode, IgG low EBV-hepatitis/-CMP | N | 1040 | CR | Y/steroids | MSD/6/6/PBSC | Thymoglobulin 7.5 | 2.4 | 9.7 | 53 | 17 | 14 |
3 | XLP1/SH2D1A | M | 7 y | IgG low, DLBCL 2017 | N | N/A | CR | N/DLBCL chemotherapy | MUD/10/10/BM | Alemtuzumab 0.6 | 7.23 | 17 | 67 | 20 | 16 |
4 | XLP1/SH2D1A | M | 3.8 y | Developmental regression ADEM | Y | 14 | PR | N/IVIG, steroids, CY | MUD/9/10/BM | Alemtuzumab 0.6 | 15.3 | 26.4 | 54 | 24 | 74 |
5 | CHS/LYST | F | 1 y | Nystagmus, oculocutaneous albinism | N* | NA | CR | N/no treatment | MUD/10/10/BM | Alemtuzumab 0.5 | 2.7 | 12 | 64 | 23 | 38 |
6 | FHL5/STXBP2 | F | 3 mo | HLH episode, sepsis, mild renal impairment | N | 8 | PR | Y/HLH-2004, IVIG, alemtuzumab | MSD/6/6/BM | Alemtuzumab 0.5 | 13.4 | 14 | 53 | 17 | 38 |
7 | FHL5/STXBP2 | M | 8 mo | HLH episode, failure to thrive | N | 25 | CR | Y/HLH-2004, no CSA | MSD/6/6/BM | Thymoglobulin 7.5 | 7 | 10 | 66 | 14 | 47 |
8 | FHL5/STXBP2 | M | 4 mo | HLH episode, hepatic/renal failure | N | 15 | CR | Y/HLH-2004 | UCB/9/10/cord | Alemtuzumab 0.6 | 1.15 | 7.2 | 63 | 24 | 30 |
9 | FHL5/STXBP2 | F | 3 y | Recurrent HLH episodes | N | 20 | CR | Y/HLH-2004 | MUD/10/10/BM | Alemtuzumab 0.5 | 2.25 | 17.3 | 55 | 22 | 34 |
10 | FHL3/UNC13D | M | 10 mo | HLH episode, cardiac effusion | N | 11 | CR | Y/HLH-2004 | MUD/10/10/BM | Alemtuzumab 0.6 | 8.6 | 15.6 | 64 | 20 | 17 |
11 | FHL3/UNC13D | M | 5 mo | HLH episode, focal seizures, NEC | Y | 11 | CR | Y/HLH-2004 | MUD/10/10/BM | Alemtuzumab 0.5 | 5.58 | 16 | 77 | 19 | 42 |
12 | FHL3/UNC13D | M | 10 mo | HLH episode | N | 31 | CR | Y/steroids, CSA, alemtuzumab | MUD/10/10/PBSC | Alemtuzumab 0.6 | 10 | 16 | 65 | 28 | 14 |
13 | FHL3/UNC13D | F | 9.25 y | HLH episode, GBS | Y | 29 | PR | Y/HLH-2004 | MRD/10/10/BM | ATG-N 40 | 4.59 | 11.4 | 56 | 28 | 29 |
14 | FHL3/UNC13D | F | 4 mo | HLH episode, CMV+, CMP, neurologically handicapped | Y | 12 | PR | Y/steroids | UCB/10/10/cord | Thymoglobulin 7.5 | 0.9 | 12.08 | 48 | 21 | 28 |
15 | FHL3/UNC13D | M | 5 mo | HLH episode, FTT | Y | 20 | CR | Y/HLH-2004 | MSD/6/6/BM | Thymoglobulin 7.5 | 32.2 | 19.04 | 63 | 11 | 37 |
16 | FHL3/UNC13D | M | 7 mo | HLH episode, polyserositis | N | 23 | CR | Y/HLH-2004 | MUD/10/10/BM | Alemtuzumab 0.6 | 5.55 | 13.1 | 68 | 18 | 29 |
17 | FHL3/UNC13D | F | 3.5 y | HLH episode, thrombosis of the sinus sagittalis superior | Y | 19 | CR | Y/HLH-2004 | MUD/9/10/PBSC† | Alemtuzumab 0.6 | 13.95 | 12.4 | 62 | 15 | 11 |
18 | FHL3/UNC13D | F | 5 mo | HLH episode, FTT | N | 20 | CR | Y/HLH-2004, alemtuzumab | MUD/10/10/BM | Alemtuzumab 0.6 | 10.7 | 24.6 | 65 | 15 | 40 |
19 | FHL3/UNC13D | F | 5 mo | Family history | N | NA | CR | N/CSA | MUD/10/10/BM | Alemtuzumab 0.6 | 10 | 15.4 | 65 | 15 | 26 |
20 | FHL3/UNC13D | F | 2 mo | Family history | N | NA | CR | N/N | MSD/6/6/BM | Thymoglobulin 7.5 | 24.8 | 11.4 | 65 | 28 | 23 |
21 | FHL3/UNC13D | F | 3 mo | Recurrent HLH episodes | N | 15 | CR | Y/steroids, CSA, alemtuzumab | MUD/10/10 PBSC† | Alemtuzumab 0.6 | 25 | 11.8 | 62 | 20 | 13 |
22 | FHL3/UNC13D | M | 7 mo | HLH episode | N | 20 | CR | N/N | MSD/6/6/BM | Thymoglobulin 7.5 | 6.95 | 14.4 | 55 | 31 | 43 |
23 | FHL3/UNC13D | F | 4 mo | HLH episode | N | 10 | CR | Y/HLH-2004 | MUD/10/10/BM | Alemtuzumab 0.6 | 7.3 | 8 | 73 | 15 | 14 |
24 | Heterozygous UNC13D | M | 16 mo | Recurrent HLH episodes | N | 32 | CR | Y/steroids, CSA | MUD/10/10/PBSC | Alemtuzumab 0.6 | 11.3 | 17.2 | 59 | 20 | 12 |
25 | Unknown | F | 23 mo | Recurrent HLH episodes | Y | 62 | PR | Y/HLH-2004, infliximab | MUD/10/10/PBSC† | Alemtuzumab 0.8 | 15 | 11.1 | 65 | 18 | 24 |
ADEM, acute disseminated encephalomyelitis; ANC, absolute neutrophil count; ATG-N, ATG-Neovii (Grafalon); AUC, area under the curve; BM, bone marrow; Bu, busulfan; bw, body weight; CMP, cardiomyopathy; Cum., cumulative; CY, cyclophosphamide; D, days until engraftment; DLBCL, diffuse large B-cell lymphoma; F, female; FTT, failure to thrive; GBS, Guillain-Barré-Syndrome; IgG, immunoglobulin G; IVIG, intravenous immunoglobulin; M, male; MRD, HLA-matched related donor; MSD, HLA-matched sibling donor; MUD, HLA-matched unrelated donor; N, no; NA, not applicable; NEC, necrotizing enterocolitis; PR, partial remission; tx, hematopoietic stem cell transplantation; UCB, unrelated cord blood; UPN, unique patient number; wk, weeks; XLP1, X-linked lymphoproliferative syndrome 1; Y, yes.
Neurological disease due to Chédiak-Higashi syndrome but not due to CNS involvement or HLH.
Patients treated with PBSC and CD34+ selection (CliniMACS technique) and CD3+ addback.