title: Successful treatment of secondary graft failure following unrelated cord blood transplant with hematopoietic growth factors in a pediatric patient with Fanconi anemia.
abstract: Graft failure following allogeneic HCT in Fanconi anemia is associated with significant mortality. Retransplantation may be considered; however, the limited toxicity profile of HGFs also makes them an option for the treatment of graft failure. We describe a five-yr-old female diagnosed with Fanconi anemia and marrow failure treated with HCT. The course was complicated by secondary graft failure treated successfully with HGFs including G-CSF, EPO, and romiplostim. The outcome could be related to the intervention, but could also be the natural course of recovery, including recovering from a recent CMV infection treated with ganciclovir. We found the use of HGFs to be an effective and safe alternative to the potential complications as well as morbidity and mortality associated with the use of retransplantation.
authors.affiliation: Division of Hematology, CHOC Children's Hospital, Orange, CA, USA.
authors.forename: David
authors.initials: D
authors.lastname: Buchbinder
authors.affiliation: Division of Hematology, CHOC Children's Hospital, Orange, CA, USA.
authors.forename: Loan
authors.initials: L
authors.lastname: Hsieh
authors.affiliation: Division of Hematology, CHOC Children's Hospital, Orange, CA, USA.
authors.forename: Arash
authors.initials: A
authors.lastname: Mahajerin
authors.affiliation: Division of Hematology, CHOC Children's Hospital, Orange, CA, USA.
authors.forename: Geetha
authors.initials: G
authors.lastname: Puthenveetil
authors.affiliation: Division of Hematology, CHOC Children's Hospital, Orange, CA, USA.
authors.forename: Amit
authors.initials: A
authors.lastname: Soni
authors.affiliation: Division of Hematology, CHOC Children's Hospital, Orange, CA, USA.
authors.forename: Diane
authors.initials: D
authors.lastname: Nugent
mesh_terms: D002675:Child, Preschool; D036101:Cord Blood Stem Cell Transplantation; D004359:Drug Therapy, Combination; D004921:Erythropoietin / Q000627:therapeutic use*; D005199:Fanconi Anemia / Q000628:therapy*; D005260:Female; D006084:Graft Rejection / Q000188:drug therapy*; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D006401:Hematologic Agents / Q000627:therapeutic use*; D006801:Humans; D011961:Receptors, Fc / Q000627:therapeutic use*; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use*; D013926:Thrombopoietin / Q000627:therapeutic use*; D014184:Transplantation, Homologous
chemical_list: D006401:Hematologic Agents; D011961:Receptors, Fc; D011993:Recombinant Fusion Proteins; D004921:Erythropoietin; D016179:Granulocyte Colony-Stimulating Factor; D013926:Thrombopoietin; C488777:romiplostim
keywords: Fanconi anemia; graft failure; hematopoietic cell transplantation; hematopoietic growth factors