Successful second transplantation with non-myeloablative conditioning using haploidentical donors for young patients after graft failure following double umbilical cord cell transplantation.
GF is a common and life-threatening complication of UCBT. Here, we report that successful second transplantation of five patients using G-CSF-mobilized maternal stem cells with non-myeloablative conditioning after GF following double UCBT. The median interval between the two transplants were 38 days. The first transplantation was administered after myeloablative conditioning for hematologic malignancies (n=3), and rabbit ATG in combination with cyclophosphamide for SAA (n=2). The second conditioning consisted of Flu and ATG-based non-myeloablative regimen. All five patients acquired quick and sustained engraftment after the second transplant. Treatment-related toxicity was minimal. Three patients developed acute GVHD (>grade II=1). Three patients developed chronic GVHD (limited=1, extensive=2). Severe infectious episodes were significant but manageable. With a median follow-up of 713 days (592-1127), all patients have currently had an event-free survival. These results indicate that a second transplant with non-myeloablative conditioning using mother as the donor for young patient after GF is feasible.
Liu
Huilan
H
Department of Hematology of Anhui Provincial Hospital, Anhui Medical University, Hefei, Anhui, China. liuhuilan@medmail.com.cn
Wang
Xingbing
X
Geng
Liangquan
L
Tang
Baolin
B
Tong
Juan
J
Yao
Wen
W
Wang
Zuyi
Z
Sun
Zimin
Z
D000293:Adolescent; D002648:Child; D036101:Cord Blood Stem Cell Transplantation / Q000379:methods*; D005260:Female; D006084:Graft Rejection / Q000601:surgery*; D006085:Graft Survival; D006086:Graft vs Host Disease / Q000453:epidemiology / Q000517:prevention & control; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D006402:Hematologic Diseases / Q000601:surgery*; D006648:Histocompatibility; D006801:Humans; D008297:Male; D019653:Myeloablative Agonists / Q000627:therapeutic use; D016133:Polymerase Chain Reaction; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D012086:Reoperation; D012307:Risk Factors; D013997:Time Factors; D019172:Transplantation Conditioning / Q000379:methods*; D014181:Transplantation Immunology; D016896:Treatment Outcome; D055815:Young Adult
D019653:Myeloablative Agonists; D016179:Granulocyte Colony-Stimulating Factor