Second allogeneic peripheral blood stem cell transplantation with fludarabine-based low-intensity conditioning regimen for relapsed myelodysplastic syndrome after allogeneic bone marrow transplantation.
We describe the case of a 51-year-old patient with relapsed myelodysplastic syndrome after allogeneic bone marrow transplantation (BMT), who underwent allogeneic peripheral blood stem cell transplantation (PBSCT) after conditioning with a novel regimen consisting of fludarabine, busulfan, and antithymocyte globulin. The second PBSCT was performed early, at 3 months after the initial allogeneic BMT, but it was well tolerated and complete hematologic remission was documented. The patient did not experience any early transplantation-related organ toxicity but died from opportunistic infection 6 months after the second transplantation. Our experience suggests that this novel regimen may induce remission and could be offered to patients relapsing after the first transplantation; however, the fludarabine-containing regimen might be accompanied by profound immunosuppression.
Kono
N
N
Bone Marrow Transplantation Team, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan.
Ohashi
K
K
Sasaki
E
E
Okoshi
Y
Y
Mizuchi
D
D
Mori
S
S
Akiyama
H
H
Karasawa
K
K
Kaku
H
H
Okamoto
R
R
Maeda
Y
Y
Sasaki
T
T
Okuyama
Y
Y
Hiruma
K
K
Sakamaki
H
H
D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000633:toxicity; D016026:Bone Marrow Transplantation; D017809:Fatal Outcome; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007239:Infections / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000150:complications / Q000628:therapy*; D012008:Recurrence; D019172:Transplantation Conditioning / Q000009:adverse effects* / Q000379:methods; D014184:Transplantation, Homologous / Q000009:adverse effects / Q000379:methods; D014740:Vidarabine / Q000008:administration & dosage* / Q000031:analogs & derivatives / Q000633:toxicity
D000970:Antineoplastic Agents; D014740:Vidarabine; C024352:fludarabine