title: Nonmyeloablative allogeneic bone marrow transplantation for treatment of myelodysplastic syndrome complicated by recent intracerebral hemorrhage.
abstract: 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.
authors.affiliation: Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan.
authors.forename: Korenori
authors.initials: K
authors.lastname: Ohtsubo
authors.forename: Ken
authors.initials: K
authors.lastname: Takase
authors.forename: Koji
authors.initials: K
authors.lastname: Nagafuji
authors.forename: Hideho
authors.initials: H
authors.lastname: Henzan
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Tanimoto
authors.forename: Takahiro
authors.initials: T
authors.lastname: Fukuda
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Miyamoto
authors.forename: Shoichi
authors.initials: S
authors.lastname: Inaba
authors.forename: Mine
authors.initials: M
authors.lastname: Harada
mesh_terms: 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