Published in:
01-01-2010
IGF-I Stimulates In Vivo Thymopoiesis After Stem Cell Transplantation in a Child with Omenn Syndrome
Published in: Journal of Clinical Immunology | Issue 1/2010
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Context
Children with severe combined immunodeficiency who receive a T cell-depleted hematopoietic stem cell transplantation (HSCT) have delayed immune reconstitution.
Objective
To examine the use of recombinant human insulin-like growth factor-I (rhIGF-I) therapy to stimulate thymopoiesis after HSCT.
Clinical case
A child with Omenn syndrome failed T cell reconstitution 6 months after HSCT. She started rhIGF-I therapy just before age 18 months. The initial dose (40 μg/kg twice daily) was increased every 2 weeks to a maximum dose of 120 μg/kg twice daily.
Results
The patient’s absolute T cells increased from 7 to 132/mm3 and 662/mm3 after 3 and 5 months of rhIGF-I therapy, respectively, and her blastogenic response to phytohemagglutinin normalized. Three months after discontinuation of rhIGF-I therapy, the T cells continued to increase (to 2,427/mm3) although the blastogenic response to phytohemagglutinin decreased.
Conclusion
This is the first known use of rhIGF-I therapy to help restore thymopoiesis in a child.