Allogeneic bone marrow transplantation for lysosomal storage diseases

P. M. Hoogerbrugge, O. F. Brouwer, P. Bordigoni, O. Ringden, P. Kapaun, J. J. Ortega, A. O'Meara, G. Cornu, G. Souillet, D. Frappaz, S. Blanche, A. Fischer, S. U. Walklay, Kostantin Dobrenis

Research output: Contribution to journalArticle

Abstract

Patients with lysosomal storage disorders have visceral, skeletal, and neurological abnormalities and a limited life expectancy. Bone marrow transplantation has been used to correct the metabolic defects and leads to metabolic improvements in most patients. However, the long-term effect of such therapy is uncertain. We analysed the data from 63 patients transplanted for lysosomal storage diseases. The transplant-related mortality was 10% if an HLA-identical sibling marrow donor was available (n = 40) and 20-25% if mismatched tissue was used. Data on the effect of bone transplantation on biochemical and clinical variables were available in 29 of the 63. 28 had a follow-up duration of 1.0-10.2 years; 1 patient died of disease progression in the first year after stable engraftment. 13 patients who had severe neurological symptoms at the time of transplantation showed disease progression. Engraftment of bone marrow in 5 patients with non-neuronopathic Gaucher's disease led to complete disappearance of symptoms. 11 patients had skeletal symptoms because of various mucopolysaccharidoses (MPSs). There was stabilisation of the skeletal lesions during the observation period of 1.4-6.4 years, but none of the patients showed significant regression of the skeletal symptoms. The visceral features (hepatosplenomegaly, cardiac hypertrophy, and upper airway obstruction) in these patients abated after transplantation. We could not evaluate the biochemical and clinical variables in 34 patients because of graft rejection, transplant-related mortality, or follow-up of less than 1 year. There were significant beneficial effects of bone marrow transplantation in patients with non-neuronopathic Gaucher's disease. Stabilisation of disease was observed in patients with MPS-I and MPS-II; this potential benefit needs to be confirmed by longer follow-up. Bone marrow transplantation was not effective if severe neurological symptoms were already present at the time of transplantation.

Original languageEnglish (US)
Pages (from-to)1382-1383+1398
JournalLancet
Volume345
Issue number8962
StatePublished - 1995
Externally publishedYes

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Lysosomal Storage Diseases
Homologous Transplantation
Bone Marrow Transplantation
Gaucher Disease
Transplantation
Disease Progression
Bone Marrow
Mucopolysaccharidosis II
Mucopolysaccharidoses
Mucopolysaccharidosis I
Transplants
Bone Transplantation
Mortality
Graft Rejection
Cardiomegaly
Airway Obstruction
Life Expectancy
Siblings

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Hoogerbrugge, P. M., Brouwer, O. F., Bordigoni, P., Ringden, O., Kapaun, P., Ortega, J. J., ... Dobrenis, K. (1995). Allogeneic bone marrow transplantation for lysosomal storage diseases. Lancet, 345(8962), 1382-1383+1398.

Allogeneic bone marrow transplantation for lysosomal storage diseases. / Hoogerbrugge, P. M.; Brouwer, O. F.; Bordigoni, P.; Ringden, O.; Kapaun, P.; Ortega, J. J.; O'Meara, A.; Cornu, G.; Souillet, G.; Frappaz, D.; Blanche, S.; Fischer, A.; Walklay, S. U.; Dobrenis, Kostantin.

In: Lancet, Vol. 345, No. 8962, 1995, p. 1382-1383+1398.

Research output: Contribution to journalArticle

Hoogerbrugge, PM, Brouwer, OF, Bordigoni, P, Ringden, O, Kapaun, P, Ortega, JJ, O'Meara, A, Cornu, G, Souillet, G, Frappaz, D, Blanche, S, Fischer, A, Walklay, SU & Dobrenis, K 1995, 'Allogeneic bone marrow transplantation for lysosomal storage diseases', Lancet, vol. 345, no. 8962, pp. 1382-1383+1398.
Hoogerbrugge PM, Brouwer OF, Bordigoni P, Ringden O, Kapaun P, Ortega JJ et al. Allogeneic bone marrow transplantation for lysosomal storage diseases. Lancet. 1995;345(8962):1382-1383+1398.
Hoogerbrugge, P. M. ; Brouwer, O. F. ; Bordigoni, P. ; Ringden, O. ; Kapaun, P. ; Ortega, J. J. ; O'Meara, A. ; Cornu, G. ; Souillet, G. ; Frappaz, D. ; Blanche, S. ; Fischer, A. ; Walklay, S. U. ; Dobrenis, Kostantin. / Allogeneic bone marrow transplantation for lysosomal storage diseases. In: Lancet. 1995 ; Vol. 345, No. 8962. pp. 1382-1383+1398.
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