Outcomes of a 1-day nonmyeloablative salvage regimen for patients with primary graft failure after allogeneic hematopoietic cell transplantation.
Journal Article (Journal Article)
Primary graft failure after allogeneic hematopoietic cell transplantation is a life-threatening complication. A shortened conditioning regimen may reduce the risk of infection and increase the chance of survival. Here, we report the outcome of 11 patients with hematologic diseases (median age, 44; range, 25-67 years, seven males) who received a 1-day reduced-intensity preparative regimen given as a re-transplantation for primary graft failure. The salvage regimen consisted of fludarabine, cyclophosphamide, alemtuzumab and TBI, all administered 1 day before re-transplantation. All patients received T-cell replete PBSCs from the same or a different haploidentical donor (n=10) or from the same matched sibling donor (n=1). Neutrophil counts promptly increased to >500/μL for 10 of the 11 patients at a median of 13 days. Of these, none developed grade III/IV acute GVHD. At present, 8 of the 11 patients are alive with a median follow-up of 11.2 months from re-transplantation and 5 of the 8 are in remission. In conclusion, this series suggests that our 1-day preparative regimen is feasible, leads to successful engraftment in a high proportion of patients, and is appropriate for patients requiring immediate re-transplantation after primary graft failure following reduced-intensity transplantation.
Full Text
Duke Authors
- Chao, Nelson Jen An
- Gasparetto, Cristina
- Horwitz, Mitchell Eric
- Li, Zhiguo
- Long, Gwynn Douglas
- Sullivan, Keith Michael
Cited Authors
- Kanda, J; Horwitz, ME; Long, GD; Gasparetto, C; Sullivan, KM; Chute, JP; Morris, A; Hennig, T; Li, Z; Chao, NJ; Rizzieri, DA
Published Date
- May 2012
Published In
Volume / Issue
- 47 / 5
Start / End Page
- 700 - 705
PubMed ID
- 21804612
Pubmed Central ID
- PMC3214602
Electronic International Standard Serial Number (EISSN)
- 1476-5365
Digital Object Identifier (DOI)
- 10.1038/bmt.2011.158
Language
- eng
Conference Location
- England