title: Haploidentical allogeneic haematopoietic stem cell transplantation as salvage therapy for engraftment failure after unrelated and autologous stem cell transplantation: a case report and review of the literature.
abstract: Engraftment failure is a rare but life-threatening complication of haematopoietic stem cell transplantation (HSCT) and treatment of this condition is often challenging. This case report describes a patient with acute myeloid leukaemia and engraftment failure after unrelated donor allogeneic stem cell transplantation. Rescue treatment with granulocyte-colony stimulating factor and reinfusion of autologous 'back-up' stem cells failed, but transplantation of haploidentical donor stem cells following a fludarabine and antithymocyte globulin (ATG)-based conditioning regimen resulted in haematological reconstitution and long-term disease-free survival. The use of haploidentical donor stem cell transplantation as salvage therapy after engraftment failure in adult patients has not, to the authors' knowledge, been previously reported. Additionally, a review of the relevant literature is presented. This case report and literature review suggest that reinfusion of cryopreserved 'back-up' haematopoietic stem cells is a safe and effective salvage therapy for engraftment failure after allogeneic HSCT. Haploidentical donor stem cell transplantation after a fludarabine and ATG-based conditioning regimen could provide effective second-line therapy in adult patients.
authors.affiliation: Bone Marrow Transplantation Centre, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Y-M
authors.initials: YM
authors.lastname: Tan
authors.forename: H-R
authors.initials: HR
authors.lastname: Fu
authors.forename: Y
authors.initials: Y
authors.lastname: Luo
authors.forename: J-M
authors.initials: JM
authors.lastname: Shi
authors.forename: X-J
authors.initials: XJ
authors.lastname: Ye
authors.forename: Y-L
authors.initials: YL
authors.lastname: Zheng
authors.forename: H-W
authors.initials: HW
authors.lastname: Xiao
authors.forename: Y-X
authors.initials: YX
authors.lastname: Hu
authors.forename: H
authors.initials: H
authors.lastname: Huang
mesh_terms: D000328:Adult; D006084:Graft Rejection; D006239:Haplotypes; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000601:surgery*; D008297:Male; D012074:Remission Induction; D016879:Salvage Therapy; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous