Long-term outcome of a successful cord blood stem cell transplant in mevalonate kinase deficiency.

Abstract

Mevalonate kinase deficiency (MKD) is a rare autosomal recessive inborn error of metabolism with an autoinflammatory phenotype that may be expressed as a spectrum of disease phenotypes, from those with prevailing autoinflammatory syndrome and variable response to anti-inflammatory therapies, to mevalonic aciduria, which is associated with dysmorphic features, severe neurologic involvement, and the worst prognosis. We describe a boy, aged 2 years, 10 months, with severe phenotype of mevalonate kinase deficiency who underwent allogeneic hematopoietic stem cell transplantation (HSCT) from HLA-identical unrelated cord blood because his condition had failed to improve with antiinflammatory treatment as first-line therapy and an anticytokine drug as second-line therapy. The child had a sustained remission of febrile attacks and inflammation after transplant, and during a 5-year follow-up period, psychomotor and neurologic development were normal, without signs of underlying disease or late transplant-related effects. This case confirms that allogeneic HSCT is a safe and effective cure for patients affected by MKD in whom anticytokine drugs alone are insufficient for the management of autoinflammatory syndrome and for the unfavorable outcome of the disease.

• Authors: Stefano Giardino, Edoardo Lanino, Giuseppe Morreale, Annalisa Madeo, Maja Di Rocco, Marco Gattorno, Maura Faraci
• Journal: Pediatrics (Pediatrics) Vol. 135 Issue 1 Pg. e211-5 (Jan 2015) ISSN: 1098-4275 [Electronic] United States
• PMID: 25535259 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2015 by the American Academy of Pediatrics.

Topics

• Child, Preschool
• Cord Blood Stem Cell Transplantation
• Humans
• Male
• Mevalonate Kinase Deficiency (surgery)
• Remission Induction
• Treatment Outcome