Leukocyte adhesion deficiency type III: clinical features and treatment with stem cell transplantation

J Pediatr Hematol Oncol. 2015 May;37(4):264-8. doi: 10.1097/MPH.0000000000000228.

Abstract

Leukocyte adhesion deficiency type III (LADIII) is an autosomal recessive disorder that presents with a severe leukocyte adhesion defect and a Glanzmann-type thrombocytopathy. Hematopoietic stem cell transplantation (HSCT)--the only definitive treatment for LADIII--appears to have a high rate of complications. In this study, we describe a new group of patients with LADIII, highlighting further clinical and immunologic aspects of this disease, and reevaluating the effectiveness of HSCT for its treatment. The patients had clinical and laboratory findings consistent with LADIII. Molecular analysis confirmed the presence of a mutation in the kindlin-3 gene. HSCT was carried out in 3 patients and was successful in 2. The diagnosis of LADIII should be considered in all patients who present with recurrent infections and a bleeding diathesis, regardless of the leukocyte count. LADIII is a primary immune deficiency, which can be successfully corrected by bone marrow transplantation if applied early in the course of the disease using appropriate conditioning.

MeSH terms

  • Child, Preschool
  • Female
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Infant
  • Leukocyte-Adhesion Deficiency Syndrome / blood
  • Leukocyte-Adhesion Deficiency Syndrome / diagnostic imaging
  • Leukocyte-Adhesion Deficiency Syndrome / genetics
  • Leukocyte-Adhesion Deficiency Syndrome / therapy*
  • Male
  • Membrane Proteins / genetics
  • Neoplasm Proteins / genetics
  • Neutrophils / physiology
  • Radiography

Substances

  • FERMT3 protein, human
  • Membrane Proteins
  • Neoplasm Proteins

Supplementary concepts

  • Leukocyte Adhesion Deficiency, Type III