Hematopoietic stem cell transplantation in mucopolysaccharidosis type IIIA: A case description and comparison with a genotype-matched control group.
Mol Genet Metab Rep
; 23: 100578, 2020 Jun.
Article
in En
| MEDLINE
| ID: mdl-32226768
ABSTRACT
BACKGROUND:
Mucopolysaccharidosis type IIIA (MPS IIIA, Sanfilippo A syndrome) is a chronic progressive neurodegenerative storage disorder caused by a deficiency of lysosomal sulfamidase. The clinical hallmarks are sleep disturbances, behavioral abnormalities and loss of cognitive, speech and motor abilities. Affected children show developmental slowing from the second year of life, dementia occurs by the age of 5â¯years followed by death in the second decade of life. Only a few studies concerning HSCT in MPS IIIA have been published and do not document a clear benefit of treatment.METHODS:
The present study summarizes the clinical outcome of a girl with MPS IIIA who received HSCT at the age of 2.5â¯years. Her clinical course was compared with the natural history of six untreated MPS IIIA patients carrying the same mutations (p.R74C and p. R245H) in the SGSH-gene.RESULTS:
Eight years after successful HSCT, the patient showed a global developmental delay. However, cognitive abilities continued to develop, albeit very slowly. There was no sign of regression. She could talk in short sentences, had good motor abilities and performed basic daily living activities by herself. She did not present with sleeping problems, but behavioral abnormalities were profound. In contrast, the six untreated patients with identical mutations in the SGSH-gene showed the typical progressive course of disease with early and continuous loss of abilities.CONCLUSIONS:
The present data suggest a beneficial effect of HSCT performed at an early stage of MPS IIIA on cognitive skills, motor function and quality of life.
AEq, age-equivalent score; ATG, antithymocyte globulin; Avg., Average; DQ, developmental quotient; FPSS, four point scoring system; GAG, Glykosaminoglycans; HSCT; HSCT, hematopoietic stem cell transplantation; ICLD, International Center for Lysosomal Disorders; MPS IH, mucopolysaccharidosis type I (Hurler syndrome); MPS IIIA; MPS IIIA, mucopolysaccharidosis type IIIA; MPS IIIB, mucopolysaccharidosis type IIIB; Mucopolysaccharidosis type III; Natural history; SGSH, N-sulfoglucosamine sulfohydrolase; Sanfilippo syndrome; Stem cell transplantation; TDS, total disability score; UCBT, umbilical cord blood-derived hematopoietic stem cell transplantation; VABS-II, Vineland Adaptive Behavior Scales; y, years
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Aspects:
Patient_preference
Language:
En
Journal:
Mol Genet Metab Rep
Year:
2020
Document type:
Article
Affiliation country:
Germany