Case Report

Allogeneic Transplant in ELANE and MEFV Mutation Positive Severe Cyclic Neutropenia: Review of Prognostic Factors for Secondary Severe Events

Table 2

Summary of relevant literature of SCN and HSCT.

Article referenceSubjectsDemographicsTreatmentConclusion

[9]14 y/o male with SCNHSCT: matched unrelated donor (MUD)“HSCT is a useful treatment for SCN patients, especially those who are at high risk for leukemic transformation”

[10]1360–43 y/o male and females with SCNHSCT
(i) 61 HLA matched related donors
(ii) 61 HLA-MUD
(iii) 14 mismatched donors
“3-year overall survival (OS) was 82%, and transplant-related mortality (TRM) was 17%… Cumulative incidence (1 year) of chronic GVHD was 20%”

[11]7 (one subject transplanted twice)2.8–28 y/o males and females with SCNHSCT
(i) 3 HLA matched siblings
(ii) 3 HLA-MUD
(iii) 2 cord blood
“Two of seven (29%) patients died; both had MDS/L… one patient has chronic GVHD 2 years post-transplant”

[12]180.2–16.7 y/o males and females with SCNHSCT
(i) 9 HLA matched siblings
(ii) 9 HLA-MUD
“Engraftment occurred at the first HSCT in 12 patients, four patients received a second HSCT for graft failure, and two patients died. The cause of death was renal failure and graft failure at the first and second HSCT, respectively. The cumulative incidence of grade II–IV acute GVHD and TRM at the first transplantation was 11% and 5.6%, respectively”

[13]N/a. Review of guidelines and treatmentsMales and females with SCN, leukocyte adhesion deficiency, and chronic granulomatous diseaseHSCT with matched and medically unrelated donors“Allogeneic stem cell transplantation and, possibly, gene-replacement therapy are the only curative treatments available”

[14]Review of 300 patients on Severe Chronic Neutropenia International Registry (SCNIR)Males and females with SCN(i) GCSF
(ii) HSCT
“More than 90% of patients respond to recombinant human (rHu) G-CSF with ANCs that can be maintained at approximately 1.0 × 10(9)/L… Hematopoietic stem cell transplantation (HSCT) is still the only available treatment for patients refractory to rHuG-CSF treatment”

[15]600 patients with CN collected by the SCNIRMales and females with SCN(i) GCSF
(ii) HSCT
“In recent analyses the influence of the G-CSF dose required to achieve neutrophil response (ANC > 1,000/microL) in the risk of developing acute myeloid leukemia (AML) has been reported”

[7]101 SCN, 9 of which received HSCTMales and females with SCNHSCT
(i) 2 HLA matched related donors
(ii) 7 HLA-MUD
“HSCT is feasible for patients with SCN who do not respond to G-CSF, who have malignant transformation, or who are at a high risk of malignant transformation, even if an HLA-identical sibling donor is not available”

[16]300 patients from SCNIRMales and females with SCN(i) GCSF
(ii) HSCT
“Adverse events documented in this group of patients include splenomegaly, thrombocytopenia, osteoporosis and malignant transformation into MDS/leukemia. If and how rHuG-CSF treatment impacts on these adverse events remains unclear since there are no historical controls for comparison. For those patients who are refractory to rHuG-CSF treatment and continue to have severe and often life-threatening bacterial infections, hematopoietic stem cell transplantation (HSCT) is still the only currently available treatment”

[17]N/a (review of characteristics, diagnosis, management, and genetic counseling)Males and females with SCNGCSF
(i) HSCT
“Treatment with granulocyte colony-stimulating factor (G-CSF) ameliorates symptoms and reduces infections in almost all affected individuals. For affected individuals with a well-matched donor, hematopoietic stem cell transplantation (HSCT) may be the preferred treatment option. HSCT is the only alternative therapy for individuals with congenital neutropenia who are refractory to high-dose G-CSF or who undergo malignant transformation”