Fludarabine-based reduced intensity  conditioning regimens for allogeneic  hematopoietic stem cell transplantation  in patients with aplastic anemia and  fungal infections.
Eighteen patients (12 men and 6 women) with aplastic anemia and active fungal infections (10 proven/probable; 8 possible) underwent stem cell transplantation using fludarabine combined with cyclophosphamide or total body irradiation. Peripheral blood stem cells (PBSC) were the main graft source and a combination of cyclosporine with either methotrexate or methylprednisolone was used for graft versus host disease prophylaxis. Fourteen patients (77.8%) achieved neutrophil engraftment after a median time of 11 d, while four died of fungal sepsis. Resolution of fungal infection occurred in 60% of patients with proven/probable infections and in 100% with possible fungal infections. At a median follow up of 30 months, 11 patients (61.1%) were alive and well. Fludarabine-based conditioning regimens with PBSC transplantation can be used successfully in patients with aplastic anemia and fungal infections.
George
Biju
B
Department of Haematology, Christian Medical College, Vellore, Tamil Nadu, India. biju@cmcvellore.ac.in
Mathews
Vikram
V
Viswabandya
Auro
A
Srivastava
Alok
A
Chandy
Mammen
M
D000293:Adolescent; D000328:Adult; D000741:Anemia, Aplastic / Q000628:therapy*; D000935:Antifungal Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D005260:Female; D006085:Graft Survival; D006086:Graft vs Host Disease / Q000276:immunology / Q000517:prevention & control / Q000601:surgery; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D009181:Mycoses / Q000382:microbiology / Q000628:therapy*; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous; D014740:Vidarabine / Q000008:administration & dosage / Q000031:analogs & derivatives; D014916:Whole-Body Irradiation; D055815:Young Adult
D000935:Antifungal Agents; D003520:Cyclophosphamide; D014740:Vidarabine; C024352:fludarabine