CASE REPORT
First hematopoietic stem cell transplantation in a child with late infantile Krabbe disease in Poland
 
More details
Hide details
1
Department of Pediatric Bone Marrow Transplantation, Oncology and Hematology, Wroclaw Medical University, Wroclaw, Poland
 
 
Submission date: 2021-01-07
 
 
Final revision date: 2021-02-19
 
 
Acceptance date: 2021-02-19
 
 
Publication date: 2021-03-28
 
 
Pediatr Pol 2021;96(1):68-70
 
KEYWORDS
TOPICS
ABSTRACT
Krabbe disease (KD) is a lysosomal storage disorder, caused by a deficiency of galactocerebrosidase (GALC) or a mutation in the prosaposin gene, which leads to psychosine accumulation. Consequently, demyelination and degradation of the nervous system occur. Newborns with early infantile Krabbe disease usually present with poor feeding, irritability, hypertonicity, deafness and visual impairment. They usually die, unless transplanted with hematopoietic stem cells (HSC) during the 1st month of life. Patients with late form KD have heterogeneous symptoms, like ataxia or spastic paresis followed by slow progression. Therapeutic options are limited and hematopoietic stem cell transplantation (HSCT) remains the only life-saving method. In this report, we describe the first HSCT in late-infantile Krabbe disease in Poland. The post-transplant period was complicated by graft versus host disease (GvHD), veno-occlusive disease (VOD), mucositis and impairment of renal function. The 5-year follow-up was uneventful, confirming clinical efficacy of the HSCT.
REFERENCES (17)
1.
Duffner PK, Barczykowski A, Kay DM, et al. Later onset phenotypes of Krabbe disease: Results of the world-wide registry. Pediatr Neurol 2012; 46: 298-306.
 
2.
Suzuki K, Suzuki Y. Globoid cell leucodystrophy (Krabbe’s disease): deficiency of galactocerebroside beta-galactosidase. Proc Natl Acad Sci U S A 1970; 66: 302-309.
 
3.
Bascou N, Derenzo A, Poe MD, et al. A prospective natural history study of Krabbe disease in a patient cohort with onset between 6 months and 3 years of life. Orphanet J Rare Dis 2018; 13: 126.
 
4.
Escolar ML, West T, Dallavecchia A, et al. Clinical management of Krabbe disease. J Neurosci Res 2016; 94: 1118-1125.
 
5.
Puckett RL, Orsini JJ, Pastores GM, et al. Krabbe disease: clinical, biochemical and molecular information on six new patients and successful retrospective diagnosis using stored newborn screening cards. Mol Genet Metab 2012; 105: 126-131.
 
6.
Morse LE, Rosman NP. Myoclonic seizures in Krabbe disease: a unique presentation in late-onset type. Pediatr Neurol 2006; 35: 154-157.
 
7.
Allewelt H, Taskindoust M, Troy J, et al. Long-term functional outcomes after hematopoietic stem cell transplant for early infantile Krabbe disease. Biol Blood Marrow Transplant 2018; 24: 2233-2238.
 
8.
Lim ZY, Ho AYL, Abrahams S, et al. Sustained neurological improvement following reduced-intensity conditioning allogeneic haematopoietic stem cell transplantation for late-onset Krabbe disease. Bone Marrow Transplant 2008; 41: 831-832.
 
9.
Corbacioglu S, Carreras E, Ansari M, et al. Diagnosis and severity criteria for sinusoidal obstruction syndrome/veno-occlusive disease in pediatric patients: A new classification from the European society for blood and marrow transplantation. Bone Marrow Transplant 2018; 53: 138-145.
 
10.
Sharp ME, Laule C, Nantel S, et al. Stem cell transplantation for adult-onset krabbe disease: report of a case. JIMD Rep 2013; 10: 57-59.
 
11.
McGraw P, Liang L, Escolar M, et al. Krabbe disease treated with hematopoietic stem cell transplantation: Serial assessment of anisotropy measurements – initial experience. Radiology 2005; 236: 221-230.
 
12.
Kwon JM, Matern D, Kurtzberg J, et al. Consensus guidelines for newborn screening, diagnosis and treatment of infantile Krabbe disease. Orphanet J Rare Dis 2018; 13: 30.
 
13.
Krivit W, Shapiro EG, Peters C, et al. Hematopoietic stem-cell transplantation in globoid-cell leukodystrophy. N Engl J Med 1998; 338: 1119-1126.
 
14.
Laule C, Vavasour IM, Shahinfard E, et al. Hematopoietic stem cell transplantation in late-onset Krabbe disease: no evidence of  worsening demyelination and axonal loss 4 years post-allograft. J Neuroimaging 2018; 28: 252-255.
 
15.
Wright MD, Poe MD, DeRenzo A, et al. Developmental outcomes of cord blood transplantation for Krabbe disease: A 15-year study. Neurology 2017; 89: 1365-1372.
 
16.
Caniglia M, Rana I, Pinto RM, et al. Allogeneic bone marrow transplantation for infantile globoid-cell leukodystrophy (Krabbe’s disease). Pediatr Transplant 2002; 6: 427-431.
 
17.
Dalle JH, Giralt SA. Hepatic veno-occlusive disease after hematopoietic stem cell transplantation: risk factors and stratification, prophylaxis, and treatment. Biol Blood Marrow Transplant 2016; 22: 400-409.
 
Journals System - logo
Scroll to top