title: Second transplant with two unrelated cord blood units for early graft failure after cord blood transplantation for thalassemia.
abstract: Early GF is a frequent complication following hematopoietic stem cell transplantation for patients with thalassemia. We report the outcome of double-unit CBT in three patients who developed early GF after CBT. The initial conditioning regimen consisted of i.v. Bu 14 mg/kg (day -9 to -6), i.v. Cy 200 mg/kg (day -5 to -2) and ATG at 120 mg/kg (day -4 to -1). They received GVHD prophylaxis with cyclosporine-A from day -3 and a short course of methylprednisolone (1 mg/kg i.v., every 12 h on days 5-19 with a taper, thereafter 25% decrease every other day). The interval between two transplants was seven and 10 months. The retransplant recipients were preconditioned with i.v. Bu 14 mg/kg (day -7 to -4), i.v. Cy 120 mg/kg (day -3 to -2) and ATG at 150 mg/kg (day -5 to -1 and +1 to +5). GVHD prophylaxis regimen was the same as the first transplant. Neutrophil engraftment were observed in all patients between day +15 and +26. All are alive, between nine and 11 months after retransplant. Our group reported successful utilization of double umblical cord blood grafts in thalassemia patients with early GF.
authors.affiliation: Division of Hematology and Oncology, Department of Pediatrics, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Tang-Her
authors.initials: TH
authors.lastname: Jaing
authors.forename: Iou-Jih
authors.initials: IJ
authors.lastname: Hung
authors.forename: Chao-Ping
authors.initials: CP
authors.lastname: Yang
authors.forename: Ming-Horng
authors.initials: MH
authors.lastname: Tsai
authors.forename: Wen-I
authors.initials: WI
authors.lastname: Lee
authors.forename: Chien-Feng
authors.initials: CF
authors.lastname: Sun
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D036101:Cord Blood Stem Cell Transplantation / Q000379:methods*; D016572:Cyclosporine / Q000494:pharmacology; D005260:Female; D005312:Fetal Blood / Q000166:cytology*; D006085:Graft Survival; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000494:pharmacology; D009504:Neutrophils / Q000378:metabolism; D013997:Time Factors; D019172:Transplantation Conditioning / Q000379:methods*; D017086:beta-Thalassemia / Q000628:therapy*
chemical_list: D016572:Cyclosporine; D008775:Methylprednisolone