title: Outcomes of a second non-myeloablative allogeneic stem cell transplantation following graft rejection.
abstract: Following initial graft rejection, a second attempt at allogeneic immunotherapy is often contemplated, but data on the success is limited. We therefore report on 11 patients with hematologic malignancies, renal cell cancer or marrow failure who underwent a second reduced-intensity regimen for primary or secondary graft failure. Nine of the 11 patients initially engrafted with the second attempt including two of four who used the same donor. One of the patients engrafted after the third attempt using a different donor and conditioning regimen. There were two treatment-related deaths. Four patients died from progressive disease 1-9 months after the second transplant. Two patients are still in recovery phase less than 1 year from the second transplant. Long-term remission is possible and three patients are alive in complete remission.
authors.affiliation: Division of Stem Cell Therapy, Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA.
authors.forename: B J
authors.initials: BJ
authors.lastname: Byrne
authors.forename: M
authors.initials: M
authors.lastname: Horwitz
authors.forename: G D
authors.initials: GD
authors.lastname: Long
authors.forename: C
authors.initials: C
authors.lastname: Gasparetto
authors.forename: K M
authors.initials: KM
authors.lastname: Sullivan
authors.forename: J
authors.initials: J
authors.lastname: Chute
authors.forename: N J
authors.initials: NJ
authors.lastname: Chao
authors.forename: D A
authors.initials: DA
authors.lastname: Rizzieri
mesh_terms: D000328:Adult; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000628:therapy; D006084:Graft Rejection; D006086:Graft vs Host Disease / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D007680:Kidney Neoplasms / Q000628:therapy; D015470:Leukemia, Myeloid, Acute / Q000628:therapy; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000628:therapy; D014184:Transplantation, Homologous; D016896:Treatment Outcome