| Title | Re-Transplantation from the Same Unrelated Donor in Three Adolescents with Severe Aplastic Anemia After Graft Rejection. | | Author(s) | Führer M, Claviez A, Klein B, Humpe A, Schrauder A | | Institution | Ludwig-Maximilian-University, Dr. von Haunersches Kinderspital, Department of Pediatric Oncology and Hematology, Munich, Germany. | | Source | Klin Padiatr 2009 Nov; 221(6):358-361. | | Abstract | Hematopoietic stem cell transplantation (HSCT) from a matched unrelated donor (MUD) has become the accepted salvage treatment for patients with severe aplastic anemia (SAA) lacking a matched sibling donor and failing immunosuppressive treatment. However, non-engraftment and early rejection remain main reasons for treatment related morbidity and mortality. We report on three adolescents who were grafted from MUD, rejected their graft and were re-grafted 47-51 days after first HSCT from the same donor. For conditioning, fludarabine, cyclophosphamide, ATG and/or OKT3 in combination with total lymphoid irradiation was used. Unmanipulated peripheral blood stem cells at a minimum dose of 8x10 (6)/kg CD34+cells were infused. Acute toxicity was low. Two patients are alive and well for more than 3 years, one patient developed extended chronic graft-versus-host disease from which he died 34 months after second HSCT. Re-transplantation from MUD in the case of non-engraftment or rejection from the same donor is possible following immunoablation combined with intensive serotherapy in young patients with SAA. | | Language | ENG | | Pub Type(s) | JOURNAL ARTICLE
| | PubMed ID | 19890787 |
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