Pseudoautologous blood stem cell transplantation for refractory chronic graft-versus-host disease.
A female patient with AML received an allogeneic BMT from her brother. She experienced two relapses managed with chemotherapy and donor leukocyte infusions. The patient subsequently developed extensive therapy-refractory chronic GVHD. Pseudoautologous blood stem cell transplantation was performed as a salvage treatment for chronic GVHD. Her blood stem cells were easily mobilized with cyclophosphamide and G-CSF. The conditioning regimen was well tolerated and consisted of 200 mg/kg cyclophosphamide and horse-derived antithymocyte globulin. A total of 4.03 x 10(6)/kg CD34+ cells were infused and hematological recovery was rapid. Chronic GVHD improved with the ability to taper steroids. Nine months post transplantation the patient died from leukemia.
Pusic
I
I
University of Nebraska Medical Center, Department of Internal Medicine, Section of Oncology and Hematology, 987680 Nebraska Medical Center, Omaha, NE 68198-7680, USA.
Pavletic
S Z
SZ
Kessinger
A
A
Tarantolo
S R
SR
Bishop
M R
MR
D000328:Adult; D001327:Autoimmune Diseases / Q000209:etiology / Q000628:therapy; D002908:Chronic Disease; D017809:Fatal Outcome; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000628:therapy; D008297:Male; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous