Long-term outcome of Hurler syndrome patients after hematopoietic cell transplantation: an international multicenter study.

Published

Journal Article

Mucopolysaccharidosis type I-Hurler syndrome (MPS-IH) is a lysosomal storage disease characterized by multisystem morbidity and death in early childhood. Although hematopoietic cell transplantation (HCT) has been performed in these patients for more than 30 years, large studies on the long-term outcome of patients with MPS-IH after HCT are lacking. The goal of this international study was to identify predictors of the long-term outcome of patients with MPS-IH after successful HCT. Two hundred seventeen patients with MPS-IH successfully engrafted with a median follow-up age of 9.2 years were included in this retrospective analysis. Primary endpoints were neurodevelopmental outcomes and growth. Secondary endpoints included neurologic, orthopedic, cardiac, respiratory, ophthalmologic, audiologic, and endocrinologic outcomes. Considerable residual disease burden was observed in the majority of the transplanted patients with MPS-IH, with high variability between patients. Preservation of cognitive function at HCT and a younger age at transplantation were major predictors for superior cognitive development posttransplant. A normal α-l-iduronidase enzyme level obtained post-HCT was another highly significant predictor for superior long-term outcome in most organ systems. The long-term prognosis of patients with MPS-IH receiving HCT can be improved by reducing the age at HCT through earlier diagnosis, as well as using exclusively noncarrier donors and achieving complete donor chimerism.

Full Text

Duke Authors

Cited Authors

  • Aldenhoven, M; Wynn, RF; Orchard, PJ; O'Meara, A; Veys, P; Fischer, A; Valayannopoulos, V; Neven, B; Rovelli, A; Prasad, VK; Tolar, J; Allewelt, H; Jones, SA; Parini, R; Renard, M; Bordon, V; Wulffraat, NM; de Koning, TJ; Shapiro, EG; Kurtzberg, J; Boelens, JJ

Published Date

  • March 26, 2015

Published In

Volume / Issue

  • 125 / 13

Start / End Page

  • 2164 - 2172

PubMed ID

  • 25624320

Pubmed Central ID

  • 25624320

Electronic International Standard Serial Number (EISSN)

  • 1528-0020

Digital Object Identifier (DOI)

  • 10.1182/blood-2014-11-608075

Language

  • eng

Conference Location

  • United States