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X-linked lymphoproliferative disease due to SAP/SH2D1A deficiency: a multicenter study on the manifestations, management and outcome of the disease

Identifieur interne : 005F95 ( Main/Exploration ); précédent : 005F94; suivant : 005F96

X-linked lymphoproliferative disease due to SAP/SH2D1A deficiency: a multicenter study on the manifestations, management and outcome of the disease

Auteurs : Claire Booth [Royaume-Uni] ; Kimberly C. Gilmour [Royaume-Uni] ; Paul Veys [Royaume-Uni] ; Andrew R. Gennery [Royaume-Uni] ; Mary A. Slatter [Royaume-Uni] ; Helen Chapel [Royaume-Uni] ; Paul T. Heath [Royaume-Uni] ; Colin G. Steward [Royaume-Uni] ; Owen Smith [Irlande (pays)] ; Anna O'Meara [Irlande (pays)] ; Hilary Kerrigan [Irlande (pays)] ; Nizar Mahlaoui [France] ; Marina Cavazzana-Calvo [France] ; Alain Fischer [France] ; Despina Moshous [France] ; Stephane Blanche [France] ; Jana Pachlopnick-Schmid [France] ; Sylvain Latour [France] ; Genevieve De Saint-Basile [France] ; Michael Albert [Allemagne] ; Gundula Notheis [Allemagne] ; Nikolaus Rieber [Allemagne] ; Brigitte Strahm [Allemagne] ; Henrike Ritterbusch [Allemagne] ; Arjan Lankester [Pays-Bas] ; Nico G. Hartwig [Pays-Bas] ; Isabelle Meyts [Belgique] ; Alessandro Plebani [Italie] ; Annarosa Soresina [Italie] ; Andrea Finocchi [Italie] ; Claudio Pignata [Italie] ; Emilia Cirillo [Italie] ; Sonia Bonanomi [Italie] ; Christina Peters [Autriche] ; Krzysztof Kalwak [Pologne] ; Srdjan Pasic [Serbie] ; Petr Sedlacek [République tchèque] ; Janez Jazbec [Slovénie] ; Hirokazu Kanegane [Japon] ; Kim E. Nichols [États-Unis] ; I. Celine Hanson [États-Unis] ; Neena Kapoor [États-Unis] ; Elie Haddad ; Morton Cowan [États-Unis] ; Sharon Choo [Australie] ; Joanne Smart [Australie] ; Peter D. Arkwright [Royaume-Uni] ; Hubert B. Gaspar [Royaume-Uni]

Source :

RBID : PMC:3374620

Abstract

X-linked lymphoproliferative disease (XLP1) is a rare immunodeficiency characterized by severe immune dysregulation and caused by mutations in the SH2D1A/SAP gene. Clinical manifestations are varied and include hemophagocytic lymphohistiocytosis (HLH), lymphoma and dysgammaglobulinemia, often triggered by Epstein-Barr virus infection. Historical data published before improved treatment regimens shows very poor outcome. We describe a large cohort of 91 genetically defined XLP1 patients collected from centers worldwide and report characteristics and outcome data for 43 patients receiving hematopoietic stem cell transplant (HSCT) and 48 untransplanted patients. The advent of better treatment strategies for HLH and malignancy has greatly reduced mortality for these patients, but HLH still remains the most severe feature of XLP1. Survival after allogeneic HSCT is 81.4% with good immune reconstitution in the large majority of patients and little evidence of posttransplant lymphoproliferative disease. However, survival falls to 50% in patients with HLH as a feature of disease. Untransplanted patients have an overall survival of 62.5% with the majority on immunoglobulin replacement therapy, but the outcome for those untransplanted after HLH is extremely poor (18.8%). HSCT should be undertaken in all patients with HLH, because outcome without transplant is extremely poor. The outcome of HSCT for other manifestations of XLP1 is very good, and if HSCT is not undertaken immediately, patients must be monitored closely for evidence of disease progression.


Url:
DOI: 10.1182/blood-2010-06-284935
PubMed: 20926771
PubMed Central: 3374620


Affiliations:


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Le document en format XML

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<country xml:lang="fr">France</country>
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<name sortKey="Blanche, Stephane" sort="Blanche, Stephane" uniqKey="Blanche S" first="Stephane" last="Blanche">Stephane Blanche</name>
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<name sortKey="Latour, Sylvain" sort="Latour, Sylvain" uniqKey="Latour S" first="Sylvain" last="Latour">Sylvain Latour</name>
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<name sortKey="De Saint Basile, Genevieve" sort="De Saint Basile, Genevieve" uniqKey="De Saint Basile G" first="Genevieve" last="De Saint-Basile">Genevieve De Saint-Basile</name>
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<nlm:aff id="aff8">Inserm U678, Hôpital Necker-Enfants Malades, Paris, France;</nlm:aff>
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<name sortKey="Albert, Michael" sort="Albert, Michael" uniqKey="Albert M" first="Michael" last="Albert">Michael Albert</name>
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<name sortKey="Rieber, Nikolaus" sort="Rieber, Nikolaus" uniqKey="Rieber N" first="Nikolaus" last="Rieber">Nikolaus Rieber</name>
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<name sortKey="Strahm, Brigitte" sort="Strahm, Brigitte" uniqKey="Strahm B" first="Brigitte" last="Strahm">Brigitte Strahm</name>
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<name sortKey="Ritterbusch, Henrike" sort="Ritterbusch, Henrike" uniqKey="Ritterbusch H" first="Henrike" last="Ritterbusch">Henrike Ritterbusch</name>
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<name sortKey="Lankester, Arjan" sort="Lankester, Arjan" uniqKey="Lankester A" first="Arjan" last="Lankester">Arjan Lankester</name>
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<wicri:regionArea>Department of Pediatrics, Division of Immunology, Haematology, Oncology, Bone Marrow Transplantation and Autoimmune Diseases, Leiden University Medical Center, Leiden</wicri:regionArea>
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<name sortKey="Hartwig, Nico G" sort="Hartwig, Nico G" uniqKey="Hartwig N" first="Nico G." last="Hartwig">Nico G. Hartwig</name>
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<name sortKey="Meyts, Isabelle" sort="Meyts, Isabelle" uniqKey="Meyts I" first="Isabelle" last="Meyts">Isabelle Meyts</name>
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<name sortKey="Plebani, Alessandro" sort="Plebani, Alessandro" uniqKey="Plebani A" first="Alessandro" last="Plebani">Alessandro Plebani</name>
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<nlm:aff id="aff15">Department of Paediatrics, University of Brescia, Brescia, Italy;</nlm:aff>
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<wicri:regionArea>Department of Paediatrics, University of Brescia, Brescia</wicri:regionArea>
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<name sortKey="Soresina, Annarosa" sort="Soresina, Annarosa" uniqKey="Soresina A" first="Annarosa" last="Soresina">Annarosa Soresina</name>
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<nlm:aff id="aff15">Department of Paediatrics, University of Brescia, Brescia, Italy;</nlm:aff>
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<wicri:regionArea>Department of Paediatrics, University of Brescia, Brescia</wicri:regionArea>
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<name sortKey="Finocchi, Andrea" sort="Finocchi, Andrea" uniqKey="Finocchi A" first="Andrea" last="Finocchi">Andrea Finocchi</name>
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<wicri:regionArea>Department of Pediatrics, Unit of Immunoinfectivology, Children's Hospital Bambino Gesù, Tor Vergata University, Rome</wicri:regionArea>
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<name sortKey="Pignata, Claudio" sort="Pignata, Claudio" uniqKey="Pignata C" first="Claudio" last="Pignata">Claudio Pignata</name>
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<nlm:aff id="aff17">Department of Pediatrics, Federico II University, Naples, Italy;</nlm:aff>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Department of Pediatrics, Federico II University, Naples</wicri:regionArea>
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<author>
<name sortKey="Cirillo, Emilia" sort="Cirillo, Emilia" uniqKey="Cirillo E" first="Emilia" last="Cirillo">Emilia Cirillo</name>
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<nlm:aff id="aff17">Department of Pediatrics, Federico II University, Naples, Italy;</nlm:aff>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Department of Pediatrics, Federico II University, Naples</wicri:regionArea>
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<author>
<name sortKey="Bonanomi, Sonia" sort="Bonanomi, Sonia" uniqKey="Bonanomi S" first="Sonia" last="Bonanomi">Sonia Bonanomi</name>
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<nlm:aff id="aff18">Clinica Pediatrica dell'Università di Milano-Bicocca, Centro Trapianto di Midollo Osseo, Ospedale San Gerardo, Monza, Italy;</nlm:aff>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Clinica Pediatrica dell'Università di Milano-Bicocca, Centro Trapianto di Midollo Osseo, Ospedale San Gerardo, Monza</wicri:regionArea>
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<author>
<name sortKey="Peters, Christina" sort="Peters, Christina" uniqKey="Peters C" first="Christina" last="Peters">Christina Peters</name>
<affiliation wicri:level="3">
<nlm:aff id="aff19">Bone Marrow Transplantation Unit, St Anna Children's Hospital, Vienna, Austria;</nlm:aff>
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<wicri:regionArea>Bone Marrow Transplantation Unit, St Anna Children's Hospital, Vienna</wicri:regionArea>
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<settlement type="city">Vienne (Autriche)</settlement>
<region nuts="2" type="province">Vienne (Autriche)</region>
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</affiliation>
</author>
<author>
<name sortKey="Kalwak, Krzysztof" sort="Kalwak, Krzysztof" uniqKey="Kalwak K" first="Krzysztof" last="Kalwak">Krzysztof Kalwak</name>
<affiliation wicri:level="1">
<nlm:aff id="aff20">Department of Paediatric Haematology and Oncology, Medical University of Wroclaw, Wroclaw, Poland;</nlm:aff>
<country xml:lang="fr">Pologne</country>
<wicri:regionArea>Department of Paediatric Haematology and Oncology, Medical University of Wroclaw, Wroclaw</wicri:regionArea>
<wicri:noRegion>Wroclaw</wicri:noRegion>
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</author>
<author>
<name sortKey="Pasic, Srdjan" sort="Pasic, Srdjan" uniqKey="Pasic S" first="Srdjan" last="Pasic">Srdjan Pasic</name>
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<nlm:aff id="aff21">Departments of Paediatric Immunology, Pathology, and Transfusion Medicine, Mother and Child Health Institute Dr Vukan Cupić, Belgrade, Serbia;</nlm:aff>
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<author>
<name sortKey="Sedlacek, Petr" sort="Sedlacek, Petr" uniqKey="Sedlacek P" first="Petr" last="Sedlacek">Petr Sedlacek</name>
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<country xml:lang="fr">République tchèque</country>
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<affiliation wicri:level="1">
<nlm:aff id="aff23">Division of Oncology and Hematology, Department of Pediatrics, Medical Center, Ljubljana, Slovenia;</nlm:aff>
<country xml:lang="fr">Slovénie</country>
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<author>
<name sortKey="Kanegane, Hirokazu" sort="Kanegane, Hirokazu" uniqKey="Kanegane H" first="Hirokazu" last="Kanegane">Hirokazu Kanegane</name>
<affiliation wicri:level="1">
<nlm:aff id="aff24">Department of Paediatrics, Graduate School Of Medicine, University of Toyama, Toyama, Japan;</nlm:aff>
<country xml:lang="fr">Japon</country>
<wicri:regionArea>Department of Paediatrics, Graduate School Of Medicine, University of Toyama, Toyama</wicri:regionArea>
<wicri:noRegion>Toyama</wicri:noRegion>
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<author>
<name sortKey="Nichols, Kim E" sort="Nichols, Kim E" uniqKey="Nichols K" first="Kim E." last="Nichols">Kim E. Nichols</name>
<affiliation wicri:level="2">
<nlm:aff id="aff25">Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, PA;</nlm:aff>
<country xml:lang="fr">États-Unis</country>
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<region type="state">Pennsylvanie</region>
</placeName>
<wicri:cityArea>Division of Oncology, Children's Hospital of Philadelphia, Philadelphia</wicri:cityArea>
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<author>
<name sortKey="Hanson, I Celine" sort="Hanson, I Celine" uniqKey="Hanson I" first="I. Celine" last="Hanson">I. Celine Hanson</name>
<affiliation wicri:level="2">
<nlm:aff id="aff26">Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, TX;</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName>
<region type="state">Texas</region>
</placeName>
<wicri:cityArea>Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston</wicri:cityArea>
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<author>
<name sortKey="Kapoor, Neena" sort="Kapoor, Neena" uniqKey="Kapoor N" first="Neena" last="Kapoor">Neena Kapoor</name>
<affiliation wicri:level="2">
<nlm:aff id="aff27">Division of Research Immunology/Bone Marrow Transplantation, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA;</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName>
<region type="state">Californie</region>
</placeName>
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</affiliation>
</author>
<author>
<name sortKey="Haddad, Elie" sort="Haddad, Elie" uniqKey="Haddad E" first="Elie" last="Haddad">Elie Haddad</name>
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<nlm:aff id="aff28">Department of Pediatrics, and Microbiology and Immunology, Centre hospitalier universitaire Sainte-Justine, Université de Montréal, Montreal, QC;</nlm:aff>
<wicri:noCountry code="subfield">QC</wicri:noCountry>
</affiliation>
</author>
<author>
<name sortKey="Cowan, Morton" sort="Cowan, Morton" uniqKey="Cowan M" first="Morton" last="Cowan">Morton Cowan</name>
<affiliation wicri:level="2">
<nlm:aff id="aff29">Pediatric Blood and Marrow Transplant Division, University of California San Francisco Children's Hospital, San Francisco, CA;</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName>
<region type="state">Californie</region>
</placeName>
<wicri:cityArea>Pediatric Blood and Marrow Transplant Division, University of California San Francisco Children's Hospital, San Francisco</wicri:cityArea>
</affiliation>
</author>
<author>
<name sortKey="Choo, Sharon" sort="Choo, Sharon" uniqKey="Choo S" first="Sharon" last="Choo">Sharon Choo</name>
<affiliation wicri:level="1">
<nlm:aff wicri:cut="; and" id="aff30">Department of Allergy and Immunology, Royal Children's Hospital, Parkville, Australia</nlm:aff>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>Department of Allergy and Immunology, Royal Children's Hospital, Parkville</wicri:regionArea>
<wicri:noRegion>Parkville</wicri:noRegion>
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<author>
<name sortKey="Smart, Joanne" sort="Smart, Joanne" uniqKey="Smart J" first="Joanne" last="Smart">Joanne Smart</name>
<affiliation wicri:level="1">
<nlm:aff wicri:cut="; and" id="aff30">Department of Allergy and Immunology, Royal Children's Hospital, Parkville, Australia</nlm:aff>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>Department of Allergy and Immunology, Royal Children's Hospital, Parkville</wicri:regionArea>
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<author>
<name sortKey="Arkwright, Peter D" sort="Arkwright, Peter D" uniqKey="Arkwright P" first="Peter D." last="Arkwright">Peter D. Arkwright</name>
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<nlm:aff id="aff31">University of Manchester, Royal Manchester Children's Hospital, Manchester, United Kingdom</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>University of Manchester, Royal Manchester Children's Hospital, Manchester</wicri:regionArea>
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<settlement type="city">Manchester</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Manchester</region>
<settlement type="city">Manchester</settlement>
</placeName>
<orgName type="university">Université de Manchester</orgName>
</affiliation>
</author>
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<name sortKey="Gaspar, Hubert B" sort="Gaspar, Hubert B" uniqKey="Gaspar H" first="Hubert B." last="Gaspar">Hubert B. Gaspar</name>
<affiliation wicri:level="3">
<nlm:aff id="aff1">Center of Immunodeficiency, Molecular Immunology Unit, Institute of Child Health, London, United Kingdom;</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Center of Immunodeficiency, Molecular Immunology Unit, Institute of Child Health, London</wicri:regionArea>
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<settlement type="city">Londres</settlement>
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<title xml:lang="en" level="a" type="main">X-linked lymphoproliferative disease due to SAP/SH2D1A deficiency: a multicenter study on the manifestations, management and outcome of the disease</title>
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<name sortKey="Booth, Claire" sort="Booth, Claire" uniqKey="Booth C" first="Claire" last="Booth">Claire Booth</name>
<affiliation wicri:level="3">
<nlm:aff id="aff1">Center of Immunodeficiency, Molecular Immunology Unit, Institute of Child Health, London, United Kingdom;</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Center of Immunodeficiency, Molecular Immunology Unit, Institute of Child Health, London</wicri:regionArea>
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<author>
<name sortKey="Gilmour, Kimberly C" sort="Gilmour, Kimberly C" uniqKey="Gilmour K" first="Kimberly C." last="Gilmour">Kimberly C. Gilmour</name>
<affiliation wicri:level="3">
<nlm:aff id="aff1">Center of Immunodeficiency, Molecular Immunology Unit, Institute of Child Health, London, United Kingdom;</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Center of Immunodeficiency, Molecular Immunology Unit, Institute of Child Health, London</wicri:regionArea>
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<settlement type="city">Londres</settlement>
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<name sortKey="Veys, Paul" sort="Veys, Paul" uniqKey="Veys P" first="Paul" last="Veys">Paul Veys</name>
<affiliation wicri:level="3">
<nlm:aff id="aff1">Center of Immunodeficiency, Molecular Immunology Unit, Institute of Child Health, London, United Kingdom;</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Center of Immunodeficiency, Molecular Immunology Unit, Institute of Child Health, London</wicri:regionArea>
<placeName>
<settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
</placeName>
</affiliation>
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<name sortKey="Gennery, Andrew R" sort="Gennery, Andrew R" uniqKey="Gennery A" first="Andrew R." last="Gennery">Andrew R. Gennery</name>
<affiliation wicri:level="1">
<nlm:aff id="aff2">Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom;</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne</wicri:regionArea>
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<name sortKey="Slatter, Mary A" sort="Slatter, Mary A" uniqKey="Slatter M" first="Mary A." last="Slatter">Mary A. Slatter</name>
<affiliation wicri:level="1">
<nlm:aff id="aff2">Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom;</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne</wicri:regionArea>
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<name sortKey="Chapel, Helen" sort="Chapel, Helen" uniqKey="Chapel H" first="Helen" last="Chapel">Helen Chapel</name>
<affiliation wicri:level="3">
<nlm:aff id="aff3">Department of Clinical Immunology, Nuffield Department of Medicine, University of Oxford and Oxford Radcliffe Hospitals, Oxford, United Kingdom;</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Department of Clinical Immunology, Nuffield Department of Medicine, University of Oxford and Oxford Radcliffe Hospitals, Oxford</wicri:regionArea>
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<region type="country">Angleterre</region>
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<name sortKey="Heath, Paul T" sort="Heath, Paul T" uniqKey="Heath P" first="Paul T." last="Heath">Paul T. Heath</name>
<affiliation wicri:level="3">
<nlm:aff id="aff4">St George's Hospital, London, United Kingdom;</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>St George's Hospital, London</wicri:regionArea>
<placeName>
<settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
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<author>
<name sortKey="Steward, Colin G" sort="Steward, Colin G" uniqKey="Steward C" first="Colin G." last="Steward">Colin G. Steward</name>
<affiliation wicri:level="1">
<nlm:aff id="aff5">Bone Marrow Transplant Unit, Royal Hospital for Children, Bristol, United Kingdom;</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
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<author>
<name sortKey="Smith, Owen" sort="Smith, Owen" uniqKey="Smith O" first="Owen" last="Smith">Owen Smith</name>
<affiliation wicri:level="1">
<nlm:aff id="aff6">Department of Haematology and Oncology, Our Lady's Children's Hospital, Dublin, Ireland;</nlm:aff>
<country xml:lang="fr">Irlande (pays)</country>
<wicri:regionArea>Department of Haematology and Oncology, Our Lady's Children's Hospital, Dublin</wicri:regionArea>
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<author>
<name sortKey="O Meara, Anna" sort="O Meara, Anna" uniqKey="O Meara A" first="Anna" last="O'Meara">Anna O'Meara</name>
<affiliation wicri:level="1">
<nlm:aff id="aff6">Department of Haematology and Oncology, Our Lady's Children's Hospital, Dublin, Ireland;</nlm:aff>
<country xml:lang="fr">Irlande (pays)</country>
<wicri:regionArea>Department of Haematology and Oncology, Our Lady's Children's Hospital, Dublin</wicri:regionArea>
<wicri:noRegion>Dublin</wicri:noRegion>
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<author>
<name sortKey="Kerrigan, Hilary" sort="Kerrigan, Hilary" uniqKey="Kerrigan H" first="Hilary" last="Kerrigan">Hilary Kerrigan</name>
<affiliation wicri:level="1">
<nlm:aff id="aff6">Department of Haematology and Oncology, Our Lady's Children's Hospital, Dublin, Ireland;</nlm:aff>
<country xml:lang="fr">Irlande (pays)</country>
<wicri:regionArea>Department of Haematology and Oncology, Our Lady's Children's Hospital, Dublin</wicri:regionArea>
<wicri:noRegion>Dublin</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Mahlaoui, Nizar" sort="Mahlaoui, Nizar" uniqKey="Mahlaoui N" first="Nizar" last="Mahlaoui">Nizar Mahlaoui</name>
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<nlm:aff id="aff7">Unité d'Immuno-Hématologie et Rhumatologie Pédiatrique, Hôpital Necker-Enfants Malades, Assistance Publique–Hôpitaux de Paris, Paris, France;</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Unité d'Immuno-Hématologie et Rhumatologie Pédiatrique, Hôpital Necker-Enfants Malades, Assistance Publique–Hôpitaux de Paris, Paris</wicri:regionArea>
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<region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
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</author>
<author>
<name sortKey="Cavazzana Calvo, Marina" sort="Cavazzana Calvo, Marina" uniqKey="Cavazzana Calvo M" first="Marina" last="Cavazzana-Calvo">Marina Cavazzana-Calvo</name>
<affiliation wicri:level="3">
<nlm:aff id="aff7">Unité d'Immuno-Hématologie et Rhumatologie Pédiatrique, Hôpital Necker-Enfants Malades, Assistance Publique–Hôpitaux de Paris, Paris, France;</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Unité d'Immuno-Hématologie et Rhumatologie Pédiatrique, Hôpital Necker-Enfants Malades, Assistance Publique–Hôpitaux de Paris, Paris</wicri:regionArea>
<placeName>
<region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Fischer, Alain" sort="Fischer, Alain" uniqKey="Fischer A" first="Alain" last="Fischer">Alain Fischer</name>
<affiliation wicri:level="3">
<nlm:aff id="aff7">Unité d'Immuno-Hématologie et Rhumatologie Pédiatrique, Hôpital Necker-Enfants Malades, Assistance Publique–Hôpitaux de Paris, Paris, France;</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Unité d'Immuno-Hématologie et Rhumatologie Pédiatrique, Hôpital Necker-Enfants Malades, Assistance Publique–Hôpitaux de Paris, Paris</wicri:regionArea>
<placeName>
<region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Moshous, Despina" sort="Moshous, Despina" uniqKey="Moshous D" first="Despina" last="Moshous">Despina Moshous</name>
<affiliation wicri:level="3">
<nlm:aff id="aff7">Unité d'Immuno-Hématologie et Rhumatologie Pédiatrique, Hôpital Necker-Enfants Malades, Assistance Publique–Hôpitaux de Paris, Paris, France;</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Unité d'Immuno-Hématologie et Rhumatologie Pédiatrique, Hôpital Necker-Enfants Malades, Assistance Publique–Hôpitaux de Paris, Paris</wicri:regionArea>
<placeName>
<region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Blanche, Stephane" sort="Blanche, Stephane" uniqKey="Blanche S" first="Stephane" last="Blanche">Stephane Blanche</name>
<affiliation wicri:level="3">
<nlm:aff id="aff7">Unité d'Immuno-Hématologie et Rhumatologie Pédiatrique, Hôpital Necker-Enfants Malades, Assistance Publique–Hôpitaux de Paris, Paris, France;</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Unité d'Immuno-Hématologie et Rhumatologie Pédiatrique, Hôpital Necker-Enfants Malades, Assistance Publique–Hôpitaux de Paris, Paris</wicri:regionArea>
<placeName>
<region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Pachlopnick Schmid, Jana" sort="Pachlopnick Schmid, Jana" uniqKey="Pachlopnick Schmid J" first="Jana" last="Pachlopnick-Schmid">Jana Pachlopnick-Schmid</name>
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<nlm:aff id="aff7">Unité d'Immuno-Hématologie et Rhumatologie Pédiatrique, Hôpital Necker-Enfants Malades, Assistance Publique–Hôpitaux de Paris, Paris, France;</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Unité d'Immuno-Hématologie et Rhumatologie Pédiatrique, Hôpital Necker-Enfants Malades, Assistance Publique–Hôpitaux de Paris, Paris</wicri:regionArea>
<placeName>
<region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
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</author>
<author>
<name sortKey="Latour, Sylvain" sort="Latour, Sylvain" uniqKey="Latour S" first="Sylvain" last="Latour">Sylvain Latour</name>
<affiliation wicri:level="3">
<nlm:aff id="aff8">Inserm U678, Hôpital Necker-Enfants Malades, Paris, France;</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Inserm U678, Hôpital Necker-Enfants Malades, Paris</wicri:regionArea>
<placeName>
<region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="De Saint Basile, Genevieve" sort="De Saint Basile, Genevieve" uniqKey="De Saint Basile G" first="Genevieve" last="De Saint-Basile">Genevieve De Saint-Basile</name>
<affiliation wicri:level="3">
<nlm:aff id="aff8">Inserm U678, Hôpital Necker-Enfants Malades, Paris, France;</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Inserm U678, Hôpital Necker-Enfants Malades, Paris</wicri:regionArea>
<placeName>
<region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Albert, Michael" sort="Albert, Michael" uniqKey="Albert M" first="Michael" last="Albert">Michael Albert</name>
<affiliation wicri:level="3">
<nlm:aff id="aff9">Department of Pediatric Hematology/Oncology and Infection/Immunity, Dr von Haunersches Kinderspital, Munich, Germany;</nlm:aff>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>Department of Pediatric Hematology/Oncology and Infection/Immunity, Dr von Haunersches Kinderspital, Munich</wicri:regionArea>
<placeName>
<region type="land" nuts="1">Bavière</region>
<region type="district" nuts="2">District de Haute-Bavière</region>
<settlement type="city">Munich</settlement>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Notheis, Gundula" sort="Notheis, Gundula" uniqKey="Notheis G" first="Gundula" last="Notheis">Gundula Notheis</name>
<affiliation wicri:level="3">
<nlm:aff id="aff9">Department of Pediatric Hematology/Oncology and Infection/Immunity, Dr von Haunersches Kinderspital, Munich, Germany;</nlm:aff>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>Department of Pediatric Hematology/Oncology and Infection/Immunity, Dr von Haunersches Kinderspital, Munich</wicri:regionArea>
<placeName>
<region type="land" nuts="1">Bavière</region>
<region type="district" nuts="2">District de Haute-Bavière</region>
<settlement type="city">Munich</settlement>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Rieber, Nikolaus" sort="Rieber, Nikolaus" uniqKey="Rieber N" first="Nikolaus" last="Rieber">Nikolaus Rieber</name>
<affiliation wicri:level="3">
<nlm:aff id="aff9">Department of Pediatric Hematology/Oncology and Infection/Immunity, Dr von Haunersches Kinderspital, Munich, Germany;</nlm:aff>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>Department of Pediatric Hematology/Oncology and Infection/Immunity, Dr von Haunersches Kinderspital, Munich</wicri:regionArea>
<placeName>
<region type="land" nuts="1">Bavière</region>
<region type="district" nuts="2">District de Haute-Bavière</region>
<settlement type="city">Munich</settlement>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Strahm, Brigitte" sort="Strahm, Brigitte" uniqKey="Strahm B" first="Brigitte" last="Strahm">Brigitte Strahm</name>
<affiliation wicri:level="3">
<nlm:aff id="aff10">Pediatric Hematology and Oncology, Center for Pediatric and Adolescent Medicine, University of Freiburg, Freiburg, Germany;</nlm:aff>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>Pediatric Hematology and Oncology, Center for Pediatric and Adolescent Medicine, University of Freiburg, Freiburg</wicri:regionArea>
<placeName>
<region type="land" nuts="1">Bade-Wurtemberg</region>
<region type="district" nuts="2">District de Fribourg-en-Brisgau</region>
<settlement type="city">Fribourg-en-Brisgau</settlement>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Ritterbusch, Henrike" sort="Ritterbusch, Henrike" uniqKey="Ritterbusch H" first="Henrike" last="Ritterbusch">Henrike Ritterbusch</name>
<affiliation wicri:level="3">
<nlm:aff id="aff11">Center for Chronic Immunodeficiency, University Medical Center Freiburg, Freiburg, Germany;</nlm:aff>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>Center for Chronic Immunodeficiency, University Medical Center Freiburg, Freiburg</wicri:regionArea>
<placeName>
<region type="land" nuts="1">Bade-Wurtemberg</region>
<region type="district" nuts="2">District de Fribourg-en-Brisgau</region>
<settlement type="city">Fribourg-en-Brisgau</settlement>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Lankester, Arjan" sort="Lankester, Arjan" uniqKey="Lankester A" first="Arjan" last="Lankester">Arjan Lankester</name>
<affiliation wicri:level="3">
<nlm:aff id="aff12">Department of Pediatrics, Division of Immunology, Haematology, Oncology, Bone Marrow Transplantation and Autoimmune Diseases, Leiden University Medical Center, Leiden, The Netherlands;</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Department of Pediatrics, Division of Immunology, Haematology, Oncology, Bone Marrow Transplantation and Autoimmune Diseases, Leiden University Medical Center, Leiden</wicri:regionArea>
<placeName>
<settlement type="city">Leyde</settlement>
<region nuts="2" type="province">Hollande-Méridionale</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Hartwig, Nico G" sort="Hartwig, Nico G" uniqKey="Hartwig N" first="Nico G." last="Hartwig">Nico G. Hartwig</name>
<affiliation wicri:level="3">
<nlm:aff id="aff13">Department of Paediatric Infectious Disease and Immunology, Erasmus Medical Center, Sophia Children's Hospital, Rotterdam, The Netherlands;</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Department of Paediatric Infectious Disease and Immunology, Erasmus Medical Center, Sophia Children's Hospital, Rotterdam</wicri:regionArea>
<placeName>
<settlement type="city">Rotterdam</settlement>
<region nuts="2" type="province">Hollande-Méridionale</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Meyts, Isabelle" sort="Meyts, Isabelle" uniqKey="Meyts I" first="Isabelle" last="Meyts">Isabelle Meyts</name>
<affiliation wicri:level="1">
<nlm:aff id="aff14">Department of Paediatrics, University Hospital Leuven, Leuven, Belgium;</nlm:aff>
<country xml:lang="fr">Belgique</country>
<wicri:regionArea>Department of Paediatrics, University Hospital Leuven, Leuven</wicri:regionArea>
<wicri:noRegion>Leuven</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Plebani, Alessandro" sort="Plebani, Alessandro" uniqKey="Plebani A" first="Alessandro" last="Plebani">Alessandro Plebani</name>
<affiliation wicri:level="1">
<nlm:aff id="aff15">Department of Paediatrics, University of Brescia, Brescia, Italy;</nlm:aff>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Department of Paediatrics, University of Brescia, Brescia</wicri:regionArea>
<wicri:noRegion>Brescia</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Soresina, Annarosa" sort="Soresina, Annarosa" uniqKey="Soresina A" first="Annarosa" last="Soresina">Annarosa Soresina</name>
<affiliation wicri:level="1">
<nlm:aff id="aff15">Department of Paediatrics, University of Brescia, Brescia, Italy;</nlm:aff>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Department of Paediatrics, University of Brescia, Brescia</wicri:regionArea>
<wicri:noRegion>Brescia</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Finocchi, Andrea" sort="Finocchi, Andrea" uniqKey="Finocchi A" first="Andrea" last="Finocchi">Andrea Finocchi</name>
<affiliation wicri:level="3">
<nlm:aff id="aff16">Department of Pediatrics, Unit of Immunoinfectivology, Children's Hospital Bambino Gesù, Tor Vergata University, Rome, Italy;</nlm:aff>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Department of Pediatrics, Unit of Immunoinfectivology, Children's Hospital Bambino Gesù, Tor Vergata University, Rome</wicri:regionArea>
<placeName>
<settlement type="city">Rome</settlement>
<region nuts="2">Latium</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Pignata, Claudio" sort="Pignata, Claudio" uniqKey="Pignata C" first="Claudio" last="Pignata">Claudio Pignata</name>
<affiliation wicri:level="1">
<nlm:aff id="aff17">Department of Pediatrics, Federico II University, Naples, Italy;</nlm:aff>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Department of Pediatrics, Federico II University, Naples</wicri:regionArea>
<wicri:noRegion>Naples</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Cirillo, Emilia" sort="Cirillo, Emilia" uniqKey="Cirillo E" first="Emilia" last="Cirillo">Emilia Cirillo</name>
<affiliation wicri:level="1">
<nlm:aff id="aff17">Department of Pediatrics, Federico II University, Naples, Italy;</nlm:aff>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Department of Pediatrics, Federico II University, Naples</wicri:regionArea>
<wicri:noRegion>Naples</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Bonanomi, Sonia" sort="Bonanomi, Sonia" uniqKey="Bonanomi S" first="Sonia" last="Bonanomi">Sonia Bonanomi</name>
<affiliation wicri:level="1">
<nlm:aff id="aff18">Clinica Pediatrica dell'Università di Milano-Bicocca, Centro Trapianto di Midollo Osseo, Ospedale San Gerardo, Monza, Italy;</nlm:aff>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Clinica Pediatrica dell'Università di Milano-Bicocca, Centro Trapianto di Midollo Osseo, Ospedale San Gerardo, Monza</wicri:regionArea>
<wicri:noRegion>Monza</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Peters, Christina" sort="Peters, Christina" uniqKey="Peters C" first="Christina" last="Peters">Christina Peters</name>
<affiliation wicri:level="3">
<nlm:aff id="aff19">Bone Marrow Transplantation Unit, St Anna Children's Hospital, Vienna, Austria;</nlm:aff>
<country xml:lang="fr">Autriche</country>
<wicri:regionArea>Bone Marrow Transplantation Unit, St Anna Children's Hospital, Vienna</wicri:regionArea>
<placeName>
<settlement type="city">Vienne (Autriche)</settlement>
<region nuts="2" type="province">Vienne (Autriche)</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Kalwak, Krzysztof" sort="Kalwak, Krzysztof" uniqKey="Kalwak K" first="Krzysztof" last="Kalwak">Krzysztof Kalwak</name>
<affiliation wicri:level="1">
<nlm:aff id="aff20">Department of Paediatric Haematology and Oncology, Medical University of Wroclaw, Wroclaw, Poland;</nlm:aff>
<country xml:lang="fr">Pologne</country>
<wicri:regionArea>Department of Paediatric Haematology and Oncology, Medical University of Wroclaw, Wroclaw</wicri:regionArea>
<wicri:noRegion>Wroclaw</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Pasic, Srdjan" sort="Pasic, Srdjan" uniqKey="Pasic S" first="Srdjan" last="Pasic">Srdjan Pasic</name>
<affiliation wicri:level="1">
<nlm:aff id="aff21">Departments of Paediatric Immunology, Pathology, and Transfusion Medicine, Mother and Child Health Institute Dr Vukan Cupić, Belgrade, Serbia;</nlm:aff>
<country xml:lang="fr">Serbie</country>
<wicri:regionArea>Departments of Paediatric Immunology, Pathology, and Transfusion Medicine, Mother and Child Health Institute Dr Vukan Cupić, Belgrade</wicri:regionArea>
<wicri:noRegion>Belgrade</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Sedlacek, Petr" sort="Sedlacek, Petr" uniqKey="Sedlacek P" first="Petr" last="Sedlacek">Petr Sedlacek</name>
<affiliation wicri:level="3">
<nlm:aff id="aff22">Department of Paediatric Haematology and Oncology, University Hospital Motol, Charles University, Prague, Czech Republic;</nlm:aff>
<country xml:lang="fr">République tchèque</country>
<wicri:regionArea>Department of Paediatric Haematology and Oncology, University Hospital Motol, Charles University, Prague</wicri:regionArea>
<placeName>
<settlement type="city">Prague</settlement>
<region type="région" nuts="2">Bohême centrale</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Jazbec, Janez" sort="Jazbec, Janez" uniqKey="Jazbec J" first="Janez" last="Jazbec">Janez Jazbec</name>
<affiliation wicri:level="1">
<nlm:aff id="aff23">Division of Oncology and Hematology, Department of Pediatrics, Medical Center, Ljubljana, Slovenia;</nlm:aff>
<country xml:lang="fr">Slovénie</country>
<wicri:regionArea>Division of Oncology and Hematology, Department of Pediatrics, Medical Center, Ljubljana</wicri:regionArea>
<wicri:noRegion>Ljubljana</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Kanegane, Hirokazu" sort="Kanegane, Hirokazu" uniqKey="Kanegane H" first="Hirokazu" last="Kanegane">Hirokazu Kanegane</name>
<affiliation wicri:level="1">
<nlm:aff id="aff24">Department of Paediatrics, Graduate School Of Medicine, University of Toyama, Toyama, Japan;</nlm:aff>
<country xml:lang="fr">Japon</country>
<wicri:regionArea>Department of Paediatrics, Graduate School Of Medicine, University of Toyama, Toyama</wicri:regionArea>
<wicri:noRegion>Toyama</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Nichols, Kim E" sort="Nichols, Kim E" uniqKey="Nichols K" first="Kim E." last="Nichols">Kim E. Nichols</name>
<affiliation wicri:level="2">
<nlm:aff id="aff25">Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, PA;</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName>
<region type="state">Pennsylvanie</region>
</placeName>
<wicri:cityArea>Division of Oncology, Children's Hospital of Philadelphia, Philadelphia</wicri:cityArea>
</affiliation>
</author>
<author>
<name sortKey="Hanson, I Celine" sort="Hanson, I Celine" uniqKey="Hanson I" first="I. Celine" last="Hanson">I. Celine Hanson</name>
<affiliation wicri:level="2">
<nlm:aff id="aff26">Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, TX;</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName>
<region type="state">Texas</region>
</placeName>
<wicri:cityArea>Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston</wicri:cityArea>
</affiliation>
</author>
<author>
<name sortKey="Kapoor, Neena" sort="Kapoor, Neena" uniqKey="Kapoor N" first="Neena" last="Kapoor">Neena Kapoor</name>
<affiliation wicri:level="2">
<nlm:aff id="aff27">Division of Research Immunology/Bone Marrow Transplantation, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA;</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName>
<region type="state">Californie</region>
</placeName>
<wicri:cityArea>Division of Research Immunology/Bone Marrow Transplantation, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles</wicri:cityArea>
</affiliation>
</author>
<author>
<name sortKey="Haddad, Elie" sort="Haddad, Elie" uniqKey="Haddad E" first="Elie" last="Haddad">Elie Haddad</name>
<affiliation>
<nlm:aff id="aff28">Department of Pediatrics, and Microbiology and Immunology, Centre hospitalier universitaire Sainte-Justine, Université de Montréal, Montreal, QC;</nlm:aff>
<wicri:noCountry code="subfield">QC</wicri:noCountry>
</affiliation>
</author>
<author>
<name sortKey="Cowan, Morton" sort="Cowan, Morton" uniqKey="Cowan M" first="Morton" last="Cowan">Morton Cowan</name>
<affiliation wicri:level="2">
<nlm:aff id="aff29">Pediatric Blood and Marrow Transplant Division, University of California San Francisco Children's Hospital, San Francisco, CA;</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName>
<region type="state">Californie</region>
</placeName>
<wicri:cityArea>Pediatric Blood and Marrow Transplant Division, University of California San Francisco Children's Hospital, San Francisco</wicri:cityArea>
</affiliation>
</author>
<author>
<name sortKey="Choo, Sharon" sort="Choo, Sharon" uniqKey="Choo S" first="Sharon" last="Choo">Sharon Choo</name>
<affiliation wicri:level="1">
<nlm:aff wicri:cut="; and" id="aff30">Department of Allergy and Immunology, Royal Children's Hospital, Parkville, Australia</nlm:aff>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>Department of Allergy and Immunology, Royal Children's Hospital, Parkville</wicri:regionArea>
<wicri:noRegion>Parkville</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Smart, Joanne" sort="Smart, Joanne" uniqKey="Smart J" first="Joanne" last="Smart">Joanne Smart</name>
<affiliation wicri:level="1">
<nlm:aff wicri:cut="; and" id="aff30">Department of Allergy and Immunology, Royal Children's Hospital, Parkville, Australia</nlm:aff>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>Department of Allergy and Immunology, Royal Children's Hospital, Parkville</wicri:regionArea>
<wicri:noRegion>Parkville</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Arkwright, Peter D" sort="Arkwright, Peter D" uniqKey="Arkwright P" first="Peter D." last="Arkwright">Peter D. Arkwright</name>
<affiliation wicri:level="4">
<nlm:aff id="aff31">University of Manchester, Royal Manchester Children's Hospital, Manchester, United Kingdom</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>University of Manchester, Royal Manchester Children's Hospital, Manchester</wicri:regionArea>
<placeName>
<settlement type="city">Manchester</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Manchester</region>
<settlement type="city">Manchester</settlement>
</placeName>
<orgName type="university">Université de Manchester</orgName>
</affiliation>
</author>
<author>
<name sortKey="Gaspar, Hubert B" sort="Gaspar, Hubert B" uniqKey="Gaspar H" first="Hubert B." last="Gaspar">Hubert B. Gaspar</name>
<affiliation wicri:level="3">
<nlm:aff id="aff1">Center of Immunodeficiency, Molecular Immunology Unit, Institute of Child Health, London, United Kingdom;</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Center of Immunodeficiency, Molecular Immunology Unit, Institute of Child Health, London</wicri:regionArea>
<placeName>
<settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
</placeName>
</affiliation>
</author>
</analytic>
<series>
<title level="j">Blood</title>
<idno type="ISSN">0006-4971</idno>
<idno type="eISSN">1528-0020</idno>
<imprint>
<date when="2011">2011</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc>
<textClass></textClass>
</profileDesc>
</teiHeader>
<front>
<div type="abstract" xml:lang="en">
<p>X-linked lymphoproliferative disease (XLP1) is a rare immunodeficiency characterized by severe immune dysregulation and caused by mutations in the
<italic>SH2D1A/</italic>
SAP gene. Clinical manifestations are varied and include hemophagocytic lymphohistiocytosis (HLH), lymphoma and dysgammaglobulinemia, often triggered by Epstein-Barr virus infection. Historical data published before improved treatment regimens shows very poor outcome. We describe a large cohort of 91 genetically defined XLP1 patients collected from centers worldwide and report characteristics and outcome data for 43 patients receiving hematopoietic stem cell transplant (HSCT) and 48 untransplanted patients. The advent of better treatment strategies for HLH and malignancy has greatly reduced mortality for these patients, but HLH still remains the most severe feature of XLP1. Survival after allogeneic HSCT is 81.4% with good immune reconstitution in the large majority of patients and little evidence of posttransplant lymphoproliferative disease. However, survival falls to 50% in patients with HLH as a feature of disease. Untransplanted patients have an overall survival of 62.5% with the majority on immunoglobulin replacement therapy, but the outcome for those untransplanted after HLH is extremely poor (18.8%). HSCT should be undertaken in all patients with HLH, because outcome without transplant is extremely poor. The outcome of HSCT for other manifestations of XLP1 is very good, and if HSCT is not undertaken immediately, patients must be monitored closely for evidence of disease progression.</p>
</div>
</front>
</TEI>
<affiliations>
<list>
<country>
<li>Allemagne</li>
<li>Australie</li>
<li>Autriche</li>
<li>Belgique</li>
<li>France</li>
<li>Irlande (pays)</li>
<li>Italie</li>
<li>Japon</li>
<li>Pays-Bas</li>
<li>Pologne</li>
<li>Royaume-Uni</li>
<li>République tchèque</li>
<li>Serbie</li>
<li>Slovénie</li>
<li>États-Unis</li>
</country>
<region>
<li>Angleterre</li>
<li>Bade-Wurtemberg</li>
<li>Bavière</li>
<li>Bohême centrale</li>
<li>Californie</li>
<li>District de Fribourg-en-Brisgau</li>
<li>District de Haute-Bavière</li>
<li>Grand Londres</li>
<li>Grand Manchester</li>
<li>Hollande-Méridionale</li>
<li>Latium</li>
<li>Oxfordshire</li>
<li>Pennsylvanie</li>
<li>Texas</li>
<li>Vienne (Autriche)</li>
<li>Île-de-France</li>
</region>
<settlement>
<li>Fribourg-en-Brisgau</li>
<li>Leyde</li>
<li>Londres</li>
<li>Manchester</li>
<li>Munich</li>
<li>Oxford</li>
<li>Paris</li>
<li>Prague</li>
<li>Rome</li>
<li>Rotterdam</li>
<li>Vienne (Autriche)</li>
</settlement>
<orgName>
<li>Université de Manchester</li>
</orgName>
</list>
<tree>
<noCountry>
<name sortKey="Haddad, Elie" sort="Haddad, Elie" uniqKey="Haddad E" first="Elie" last="Haddad">Elie Haddad</name>
</noCountry>
<country name="Royaume-Uni">
<region name="Angleterre">
<name sortKey="Booth, Claire" sort="Booth, Claire" uniqKey="Booth C" first="Claire" last="Booth">Claire Booth</name>
</region>
<name sortKey="Arkwright, Peter D" sort="Arkwright, Peter D" uniqKey="Arkwright P" first="Peter D." last="Arkwright">Peter D. Arkwright</name>
<name sortKey="Chapel, Helen" sort="Chapel, Helen" uniqKey="Chapel H" first="Helen" last="Chapel">Helen Chapel</name>
<name sortKey="Gaspar, Hubert B" sort="Gaspar, Hubert B" uniqKey="Gaspar H" first="Hubert B." last="Gaspar">Hubert B. Gaspar</name>
<name sortKey="Gennery, Andrew R" sort="Gennery, Andrew R" uniqKey="Gennery A" first="Andrew R." last="Gennery">Andrew R. Gennery</name>
<name sortKey="Gilmour, Kimberly C" sort="Gilmour, Kimberly C" uniqKey="Gilmour K" first="Kimberly C." last="Gilmour">Kimberly C. Gilmour</name>
<name sortKey="Heath, Paul T" sort="Heath, Paul T" uniqKey="Heath P" first="Paul T." last="Heath">Paul T. Heath</name>
<name sortKey="Slatter, Mary A" sort="Slatter, Mary A" uniqKey="Slatter M" first="Mary A." last="Slatter">Mary A. Slatter</name>
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