Abstract
Allogeneic hematopoietic stem cell transplantation (SCT) is a curative treatment for severe combined immunodeficiency (SCID). However, the outcome is poor when cytomegalovirus (CMV) infection arises as a complication before SCT. Here, we report a case of SCID with CMV infection that was successfully treated by allogeneic cord blood transplantation (CBT). A 3-month-old male was admitted with fever and dyspnea. He was diagnosed as having SCID with CMV pneumonia and enterocolitis. Combined treatment with ganciclovir, intravenous immunoglobulin, and methylprednisolone pulse did not improve the CMV infection; however, the addition of foscarnet proved successful. He received CBT with a conditioning regimen comprising busulfan (4 mg/kg) and fludarabine (180 mg/m2). Neutrophils engrafted 10 days after CBT and CMV infection did not recur after transplantation. At 15 months post-transplantation, the patient remains well with no complications. Antiviral therapy before CBT might be the key to the successful outcome in this case.
