TY - JOUR
T1 - Overview of 15-year severe combined immunodeficiency in the Netherlands
T2 - towards newborn blood spot screening
AU - de Pagter, Anne P. J.
AU - Bredius, Robbert G. M.
AU - Kuijpers, Taco W.
AU - Tramper, Jelco
AU - van der Burg, Mirjam
AU - van Montfrans, JM
AU - Driessen, Gertjan J.
PY - 2015/9
Y1 - 2015/9
N2 - Severe combined immune deficiency (SCID) is a fatal primary immunodeficiency usually presenting in the first months of life with (opportunistic) infections, diarrhea, and failure to thrive. Hematopoietic stem cell transplantation (HSCT) and gene therapy (GT) are curative treatment options. The objective of the study was to assess the morbidity, mortality, and diagnostic and therapeutic delay in children with SCID in the Netherlands in the last 15 years. These data may help to judge whether SCID should be considered to be included in our national neonatal screening program. In the period 1998-2013, 43 SCID patients were diagnosed in the Netherlands, 11 of whom were atypical SCID (presentation beyond the first year). The median interval between the first symptom and diagnosis was 2 months (range 0-1173 months). The total mortality was 42 %. In total, 32 patients were treated with HSCT of whom 8 were deceased. Nine patients died due to severe infectious complications before curative treatment could be initiated.Conclusion: Because of a high mortality of patients with SCID before HSCT could be initiated, only a national newborn screening program and pre-emptive HSCT or GT will be able to improve survival of these patients.
AB - Severe combined immune deficiency (SCID) is a fatal primary immunodeficiency usually presenting in the first months of life with (opportunistic) infections, diarrhea, and failure to thrive. Hematopoietic stem cell transplantation (HSCT) and gene therapy (GT) are curative treatment options. The objective of the study was to assess the morbidity, mortality, and diagnostic and therapeutic delay in children with SCID in the Netherlands in the last 15 years. These data may help to judge whether SCID should be considered to be included in our national neonatal screening program. In the period 1998-2013, 43 SCID patients were diagnosed in the Netherlands, 11 of whom were atypical SCID (presentation beyond the first year). The median interval between the first symptom and diagnosis was 2 months (range 0-1173 months). The total mortality was 42 %. In total, 32 patients were treated with HSCT of whom 8 were deceased. Nine patients died due to severe infectious complications before curative treatment could be initiated.Conclusion: Because of a high mortality of patients with SCID before HSCT could be initiated, only a national newborn screening program and pre-emptive HSCT or GT will be able to improve survival of these patients.
KW - Severe combined immunodeficiency
KW - Primary immunodeficiency
KW - Infection
KW - Viral
KW - Bacterial
KW - Stem cell transplantation
KW - TRANSPLANTATION
U2 - 10.1007/s00431-015-2518-4
DO - 10.1007/s00431-015-2518-4
M3 - Article
SN - 0340-6199
VL - 174
SP - 1183
EP - 1188
JO - European Journal of Pediatrics
JF - European Journal of Pediatrics
IS - 9
ER -