Facilitated engraftment by intramedullary administered enriched allogeneic CD34+ cells?

An 11-year-old girl with Ph+ CML received a marrow-ablative cytoreductive regimen, but both blood and marrow grafts obtained from her two-loci-mismatched father were rejected. At the third attempt, she was directly injected with purified CD34+ blood cells from the same donor into the bone marrow cavity with regular disposable bone marrow biopsy needles. The peripheral hemogram recovered rapidly thereafter, and she maintained stable complete donor type hematopoiesis until 8 months later, when she developed renal failure due to thrombotic microangiopathy, which was the primary cause of her death. This experience suggests that we revisit an old maneuver in the light of new developments.