title: Reduced-intensity bone marrow transplantation from an alternative unrelated donor for myelodysplastic syndrome of first-donor origin.
abstract: A male patient had a relapse of myelodysplastic syndrome (MDS) 2 years after BMT from a female matched unrelated donor. Conventional cytogenetics, FISH, and short-tandem repeat chimerism analysis proved a relapse of donor origin. He underwent reduced-intensity BMT after a conditioning with fludarabine and busulfan, since he had impaired renal, liver, and pulmonary functions. Chimerism analysis on day 28 after the second BMT showed mixed chimerism of the first and the second donors, which later turned to full second-donor chimerism on day 60. He developed grade II acute GVHD of the skin and cytomegalovirus reactivation, but both were improved with methylprednisolone and ganciclovir, respectively. He remains in complete remission 6 months after the second BMT. Reduced-intensity second BMT from an alternative donor appeared to be a tolerable treatment option for donor-derived leukemia/MDS after the first conventional transplantation.
authors.affiliation: Department of Cell Therapy & Transplantation Medicine, University of Tokyo Hospital, Japan.
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Komeno
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Kanda
authors.forename: Koji
authors.initials: K
authors.lastname: Kandabashi
authors.forename: Masahito
authors.initials: M
authors.lastname: Kawazu
authors.forename: Susumu
authors.initials: S
authors.lastname: Goyama
authors.forename: Masataka
authors.initials: M
authors.lastname: Takeshita
authors.forename: Yasuhito
authors.initials: Y
authors.lastname: Nannya
authors.forename: Miyuki
authors.initials: M
authors.lastname: Niino
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Nakamoto
authors.forename: Mineo
authors.initials: M
authors.lastname: Kurokawa
authors.forename: Shiho
authors.initials: S
authors.lastname: Tsujino
authors.forename: Seishi
authors.initials: S
authors.lastname: Ogawa
authors.forename: Katsunori
authors.initials: K
authors.lastname: Aoki
authors.forename: Shigeru
authors.initials: S
authors.lastname: Chiba
authors.forename: Toru
authors.initials: T
authors.lastname: Motokura
authors.forename: Hisamaru
authors.initials: H
authors.lastname: Hirai
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects; D016026:Bone Marrow Transplantation / Q000009:adverse effects* / Q000379:methods*; D016572:Cyclosporine / Q000627:therapeutic use; D006086:Graft vs Host Disease / Q000175:diagnosis / Q000517:prevention & control; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D009190:Myelodysplastic Syndromes / Q000209:etiology* / Q000235:genetics / Q000628:therapy*; D012008:Recurrence; D012074:Remission Induction; D014019:Tissue Donors; D018183:Transplantation Chimera; D019172:Transplantation Conditioning
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine; D008727:Methotrexate