Nonmyeloablative allogeneic bone marrow transplantation for treatment of myelodysplastic syndrome complicated by recent intracerebral hemorrhage.
A patient with intracerebral hemorrhage is considered ineligible for hematopoietic stem cell transplantation (HSCT). We report a 49-year-old woman with myelodysplastic syndrome (MDS) complicated by refractoriness to platelet transfusion and intracerebral hemorrhage, who underwent allogeneic bone marrow transplantation from an HLA-identical unrelated male donor. Nine days before the scheduled transplantation, she developed dysarthria and right hemiparesis; computed tomography (CT) of the brain disclosed an acute hematoma in the left parietal lobe exceeding 3 cm in diameter. She underwent conditioning with reduced-intensity, including fludarabine (30 mg/m2/day on days -8 to -3), busulfan (4 mg/kg/day on days -6 and -5), and total body irradiation (4 Gy on day -2). Two weeks after transplantation, dysarthria and right hemiparesis began to resolve, and CT showed spontaneous resolution of the hematoma. Simultaneously, engraftment was confirmed. Thus, recent stroke may be not an absolute contraindication for HSCT.
Ohtsubo
Korenori
K
Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan.
Takase
Ken
K
Nagafuji
Koji
K
Henzan
Hideho
H
Tanimoto
Tetsuya
T
Fukuda
Takahiro
T
Miyamoto
Toshihiro
T
Inaba
Shoichi
S
Harada
Mine
M
D016026:Bone Marrow Transplantation; D002543:Cerebral Hemorrhage / Q000150:complications* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000150:complications / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous; D016896:Treatment Outcome