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.
University of Nebraska Medical Center, Department of Internal Medicine, Section of Oncology and Hematology, 987680 Nebraska Medical Center, Omaha, NE 68198-7680, USA.
I
I
Pusic
S Z
SZ
Pavletic
A
A
Kessinger
S R
SR
Tarantolo
M R
MR
Bishop
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