title: Second allogeneic peripheral blood stem cell transplantation with fludarabine-based low-intensity conditioning regimen for relapsed myelodysplastic syndrome after allogeneic bone marrow transplantation.
abstract: 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.
authors.affiliation: Bone Marrow Transplantation Team, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Kono
authors.forename: K
authors.initials: K
authors.lastname: Ohashi
authors.forename: E
authors.initials: E
authors.lastname: Sasaki
authors.forename: Y
authors.initials: Y
authors.lastname: Okoshi
authors.forename: D
authors.initials: D
authors.lastname: Mizuchi
authors.forename: S
authors.initials: S
authors.lastname: Mori
authors.forename: H
authors.initials: H
authors.lastname: Akiyama
authors.forename: K
authors.initials: K
authors.lastname: Karasawa
authors.forename: H
authors.initials: H
authors.lastname: Kaku
authors.forename: R
authors.initials: R
authors.lastname: Okamoto
authors.forename: Y
authors.initials: Y
authors.lastname: Maeda
authors.forename: T
authors.initials: T
authors.lastname: Sasaki
authors.forename: Y
authors.initials: Y
authors.lastname: Okuyama
authors.forename: K
authors.initials: K
authors.lastname: Hiruma
authors.forename: H
authors.initials: H
authors.lastname: Sakamaki
mesh_terms: 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
chemical_list: D000970:Antineoplastic Agents; D014740:Vidarabine; C024352:fludarabine