ID
45630
Descripción
Principal Investigator: Matt Zinter, MD, University of California, San Francisco, San Francisco, CA, USA MeSH: Bone Marrow Transplantation,Hematopoietic Stem Cell Transplantation,Graft vs Host Disease,Myocarditis https://www.ncbi.nlm.nih.gov/projects/gap/cgi-bin/study.cgi?study_id=phs001336 We report the case of a 15-year-old female with hypodiploid pre-B acute lymphoblastic leukemia status post allogeneic hematopoietic stem cell transplantation (HCT) from a matched unrelated male donor who presented on transplant day +75 with cardiac arrest due to ventricular fibrillation associated with fulminant myocarditis. Using conventional diagnostics, an exhaustive search for microbial pathogens in the heart biopsy as well as nasopharynx, blood, urine, and endotracheal aspirate was performed but did not uncover a candidate pathogen. The family consented to a research study for the use of unbiased next-generation genomic sequencing for pathogen identification in the myocardial biopsy. DNA sequencing was performed on 1.5 x 10sup8/sup sequencing pairs and no microbial pathogens were identified. Interestingly, a significant component of Y-chromosomal human DNA was identified, suggesting infiltration of at least 10 donor leukocytes per host cell. This finding is grossly consistent with the lymphocyte:myocyte ratio in the biopsy according to visual inspection at 40x magnification. This case merits discussion due to (1) her survival after 17 days of veno-arterial extracorporeal life support (ECLS) and (2) the possibility of cardiotropic graft versus host disease (GVHD).
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Versiones (1)
- 02/03/23 02/03/23 - Simon Heim
Titular de derechos de autor
Matt Zinter, MD, University of California, San Francisco, San Francisco, CA, USA
Subido en
2 marzo 2023
DOI
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Licencia
Creative Commons BY 4.0
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dbGaP phs001336 ECLS Survival in Pediatric HCT Recipient with Presumed Cardiac GVHD
The subject consent data table contains patient IDs, consent group information, and affection status of subject for hypodiploid pre-B acute lymphoblastic leukemia status post matched unrelated donor allogeneic hematopoietic stem cell transplant complicated by fulminant myocarditis on day +75.
- StudyEvent: SEV1
- The subject consent data table contains patient IDs, consent group information, and affection status of subject for hypodiploid pre-B acute lymphoblastic leukemia status post matched unrelated donor allogeneic hematopoietic stem cell transplant complicated by fulminant myocarditis on day +75.
- This subject sample mapping data table includes a mapping of study patient IDs to sample IDs. Samples are the final preps submitted for genotyping, sequencing, and/or expression data. For example, if one patient (subject ID) gave one sample, and that sample was processed differently to generate 2 sequencing runs, there would be two rows, both using the same subject ID, but having 2 unique sample IDs. The data table also includes sample use.
- This subject phenotype data table includes the patient's sex, race, disease onset age, hematopoietic cellular transplant (HCT) indication and type, cell source, and number of HLA matches.
- This sample attributes table includes body site where sample was collected, analyte type, tumor status, and sequencing center.
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The subject consent data table contains patient IDs, consent group information, and affection status of subject for hypodiploid pre-B acute lymphoblastic leukemia status post matched unrelated donor allogeneic hematopoietic stem cell transplant complicated by fulminant myocarditis on day +75.
- StudyEvent: SEV1
- The subject consent data table contains patient IDs, consent group information, and affection status of subject for hypodiploid pre-B acute lymphoblastic leukemia status post matched unrelated donor allogeneic hematopoietic stem cell transplant complicated by fulminant myocarditis on day +75.
- This subject sample mapping data table includes a mapping of study patient IDs to sample IDs. Samples are the final preps submitted for genotyping, sequencing, and/or expression data. For example, if one patient (subject ID) gave one sample, and that sample was processed differently to generate 2 sequencing runs, there would be two rows, both using the same subject ID, but having 2 unique sample IDs. The data table also includes sample use.
- This subject phenotype data table includes the patient's sex, race, disease onset age, hematopoietic cellular transplant (HCT) indication and type, cell source, and number of HLA matches.
- This sample attributes table includes body site where sample was collected, analyte type, tumor status, and sequencing center.
C0441833 (UMLS CUI [1,2])