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Allogeneic hematopoietic stem cell transplantation for treating severe lung involvement in Gaucher disease

Title: Allogeneic hematopoietic stem cell transplantation for treating severe lung involvement in Gaucher disease
Authors: Fu-Shiuan Lee; Hsiu-Ju Yen; Dau-Ming Niu; Giun-Yi Hung; Chih-Ying Lee; Yi-Chen Yeh; Paul Chih-Hsueh Chen; Sheng-Kai Chang; Chia-Feng Yang
Source: Molecular Genetics and Metabolism Reports, Vol 25, Iss , Pp 100652- (2020)
Publisher Information: Elsevier
Publication Year: 2020
Collection: Directory of Open Access Journals: DOAJ Articles
Subject Terms: Lysosomal storage disease; Infiltrative lung disease; Glucocerebrosidase; Medicine (General); R5-920; Biology (General); QH301-705.5
Description: Objective: To provide strategies for monitoring and treating severe lung involvement in Gaucher disease. Study design: We reviewed the chart of a 5-year-old boy who developed rapidly progressive, severe infiltrative lung involvement of Gaucher disease (GD) and improved after allogeneic hematopoietic stem cell transplant (HSCT), along with other case studies reported before December 2019. He was diagnosed with GD (homozygous mutation at c.1448 T > C, p.L483P), and started receiving enzyme replacement therapy (ERT) at 17 months old. He developed respiratory distress symptoms after 45 months of ERT; chest imaging reported diffuse interstitial infiltration of the bilateral lungs and consolidations at the right lungs. Allogeneic HSCT using cells from a matched unrelated donor was performed four months upon progressive respiratory symptoms. Results: His respiratory symptoms subsided in one month; chest imaging improvement, pulmonary function test improvement, and normalized activity of β-glucocerebrosidase were reported in three months. Conclusion: This is the first report of a patient who received early and regular ERT but developed severe infiltrative lung involvement and recovered after allogeneic HSCT. Based on study results, we suggest regular chest imaging, even for asymptomatic patients. For patients with severe lung involvement, rapid deterioration, and unresponsive to higher ERT dosages, allogeneic HSCT should be considered.
Document Type: article in journal/newspaper
Language: English
Relation: http://www.sciencedirect.com/science/article/pii/S2214426920300987; https://doaj.org/toc/2214-4269; https://doaj.org/article/7d0c48e7a2914dac87bf2baec12f3342
DOI: 10.1016/j.ymgmr.2020.100652
Availability: https://doi.org/10.1016/j.ymgmr.2020.100652; https://doaj.org/article/7d0c48e7a2914dac87bf2baec12f3342
Accession Number: edsbas.1F95F700
Database: BASE