Conditioning regimen of melphalan, fludarabine and total body irradiation in unmanipulated HLA haploidentical stem cell transplantation based on feto-maternal tolerance.
Unmanipulated hematopoietic stem cell transplantation from haploidentical family donors is frequently associated with graft failure and severe graft-versus-host disease (GVHD). We employed a myeloablative conditioning regimen consisting of 125 mg/m2 of fludarabine, 140 mg/m2 of melphalan and TBI of 10 to 12 Gy for three patients. The donor in each case was a haploidentical two-loci HLA mismatch mother or son. Engraftment failure was observed in one patient. In the other two patients, engraftment was confirmed within 15 days after transplantation. Acute and chronic GVHD was observed, but was controllable in both cases. HLA mismatched transplantation based on feto-maternal tolerance may provide an alternative option for patients who do not have HLA-matched donors.
Narimatsu
Hiroto
H
Department of Hematology and Oncology, JA Aichi Showa Hospital, Konan.
Morishita
Yoshihisa
Y
Saito
Shigeki
S
Shimada
Kazuyuki
K
Ozeki
Kazutaka
K
Kohno
Akio
A
Kato
Yukio
Y
D000328:Adult; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use*; D005260:Female; D006086:Graft vs Host Disease / Q000188:drug therapy*; D006680:HLA Antigens / Q000032:analysis; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008558:Melphalan / Q000627:therapeutic use*; D008875:Middle Aged; D014184:Transplantation, Homologous / Q000379:methods; D014740:Vidarabine / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D014916:Whole-Body Irradiation
D018906:Antineoplastic Agents, Alkylating; D006680:HLA Antigens; D007166:Immunosuppressive Agents; D014740:Vidarabine; C024352:fludarabine; D008558:Melphalan