title: Reduced intensity HLA-haploidentical BMT with post transplantation cyclophosphamide in nonmalignant hematologic diseases.
abstract: Allogeneic blood or marrow transplantation (BMT) is potentially curative for a variety of life-threatening nonmalignant hematologic diseases such as paroxysmal nocturnal hemoglobinuria (PNH) and hemoglobinopathies. The application of BMT to treat these disorders is limited by the lack of suitable donors and often end-organ damage from the underlying disease. We treated three patients with thrombotic PNH, one of whom also had sickle cell disease, with a nonmyeloablative, HLA-haploidentical BMT with post-transplant CY. Rapid engraftment without GVHD occurred in two of the patients, including the patient with sickle cell disease. Both patients are disease free with full donor chimerism and require no immunosuppressive therapy, with follow-up of 1 and 4 years, respectively. Nonmyeloablative, HLA-haploidentical BMT with post-transplant CY is a promising approach for patients with life-threatening nonmalignant hematologic disease who lack an HLA-matched sibling donor.
authors.affiliation: Division of Hematology, Johns Hopkins University School of Medicine, Baltimore, MD 21205-2196, USA. brodsro@jhmi.edu
authors.forename: R A
authors.initials: RA
authors.lastname: Brodsky
authors.forename: L
authors.initials: L
authors.lastname: Luznik
authors.forename: J
authors.initials: J
authors.lastname: Bolaños-Meade
authors.forename: M S
authors.initials: MS
authors.lastname: Leffell
authors.forename: R J
authors.initials: RJ
authors.lastname: Jones
authors.forename: E J
authors.initials: EJ
authors.lastname: Fuchs
mesh_terms: D000328:Adult; D000755:Anemia, Sickle Cell / Q000150:complications / Q000628:therapy; D016026:Bone Marrow Transplantation; D006502:Budd-Chiari Syndrome / Q000150:complications / Q000628:therapy*; D003520:Cyclophosphamide / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival / Q000187:drug effects*; D006650:Histocompatibility Testing; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008297:Male; D014184:Transplantation, Homologous
chemical_list: D007166:Immunosuppressive Agents; D003520:Cyclophosphamide