Second allogeneic peripheral blood stem cell transplantation with fludarabine-based low-intensity conditioning regimen for relapsed myelodysplastic syndrome after allogeneic bone marrow transplantation

• Published in: International journal of hematology 2001-01, Vol.73 (1), p.122-125
• Main Authors: KONO, Natsu, OHASHI, Kazuteru, MAEDA, Yoshiharu, SASAKI, Tsuneo, OKUYAMA, Yoshiki, HIRUMA, Kiyoshi, SAKAMAKI, Hisashi, SASAKI, Eisaku, OKOSHI, Yasushi, MIZUCHI, Daisuke, MORI, Shin-Ichro, AKIYAMA, Hideki, KARASAWA, Katsuyuki, KAKU, Hidefumi, OKAMOTO, Rumiko
• Format: Article
• Language: English
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Antineoplastic Agents - administration & dosage; Antineoplastic Agents - toxicity; Biological and medical sciences; Bone Marrow Transplantation; Bone marrow, stem cells transplantation. Graft versus host reaction; Fatal Outcome; Hematopoietic Stem Cell Transplantation - adverse effects; Hematopoietic Stem Cell Transplantation - methods; Humans; Infection - etiology; Male; Medical sciences; Middle Aged; Myelodysplastic Syndromes - complications; Myelodysplastic Syndromes - therapy; Recurrence; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Transplantation Conditioning - adverse effects; Transplantation Conditioning - methods; Transplantation, Homologous - adverse effects; Transplantation, Homologous - methods; Vidarabine - administration & dosage; Vidarabine - analogs & derivatives; Vidarabine - toxicity
• ISSN: 0925-5710; 1865-3774
• DOI: 10.1007/BF02981914

We describe the case of a 51-year-old patient with relapsed myelodysplastic syndrome after allogeneic bone marrow transplantation (BMT), who underwent allogeneic peripheral blood stem cell transplantation (PBSCT) after conditioning with a novel regimen consisting of fludarabine, busulfan, and antithymocyte globulin. The second PBSCT was performed early, at 3 months after the initial allogeneic BMT, but it was well tolerated and complete hematologic remission was documented. The patient did not experience any early transplantation-related organ toxicity but died from opportunistic infection 6 months after the second transplantation. Our experience suggests that this novel regimen may induce remission and could be offered to patients relapsing after the first transplantation; however, the fludarabine-containing regimen might be accompanied by profound immunosuppression.