Document Detail


Treatment of donor graft failure with nonmyeloablative conditioning of fludarabine, antithymocyte globulin and a second allogeneic hematopoietic transplantation.
MedLine Citation:
PMID:  17603511     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Graft failure is a life-threatening complication of allogeneic stem cell transplantation (SCT). We assessed the feasibility of performing a second SCT after such failure when fludarabine and antithymocyte globulin (ATG) are used for non-myeloablative conditioning and tacrolimus for graft-versus-host disease (GVHD) prophylaxis. Nine patients with SCTs for various hematologic malignancies were enrolled, eight with primary and one with secondary graft failure. The median time between the first and second SCT was 53 days. Eight patients had the same donor for their second SCT, and one had a cord blood transplant. Three patients were not evaluable because of early death; the other six had evidence of donor cell engraftment. Six of the nine patients developed acute grade II-IV GVHD, the main cause of death. Overall, we found that fludarabine and ATG conditioning before a second SCT allows engraftment of donor hematopoiesis. Future studies should include more intense GVHD prophylaxis.
Authors:
E Jabbour; G Rondon; P Anderlini; S A Giralt; D R Couriel; R E Champlin; I F Khouri
Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2007-07-02
Journal Detail:
Title:  Bone marrow transplantation     Volume:  40     ISSN:  0268-3369     ISO Abbreviation:  Bone Marrow Transplant.     Publication Date:  2007 Sep 
Date Detail:
Created Date:  2007-08-16     Completed Date:  2007-11-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8702459     Medline TA:  Bone Marrow Transplant     Country:  England    
Other Details:
Languages:  eng     Pagination:  431-5     Citation Subset:  IM    
Affiliation:
Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Antilymphocyte Serum / administration & dosage*
Feasibility Studies
Female
Graft Rejection
Graft Survival
Graft vs Host Disease / drug therapy,  prevention & control
Hematopoiesis
Hematopoietic Stem Cell Transplantation / adverse effects,  methods*
Humans
Male
Middle Aged
Pilot Projects
Salvage Therapy / methods*
Tacrolimus / therapeutic use
Transplantation Conditioning / methods*
Transplantation, Autologous
Vidarabine / administration & dosage,  analogs & derivatives*
Chemical
Reg. No./Substance:
0/Antilymphocyte Serum; 109581-93-3/Tacrolimus; 21679-14-1/fludarabine; 5536-17-4/Vidarabine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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