A fludarabine-based conditioning regimen for severe aplastic anemia
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AbstractGraft rejection is a common problem after alternative donor transplantation for patients with refractory severe aplastic anemia (SAA). Intensification of the conditioning regimen, with the inclusion of irradiation, has often been advocated to combat this problem. With this approach engraftment rate improved, but the incidence of transplant-related complications is also increased, resulting in little change in the overall outcome. We investigated the use of the combination of fludarabine, cyclophosphamide and anti-thymocyte globulin as the conditioning regimen in five multiply-transfused SAA patients. Three patients received an HLA one-antigen disparate related donor transplant, while two patients were given marrow from matched, unrelated donors. The regimen was well tolerated, with only grade I toxicity encountered. With a median follow-up of 9 months, all patients are alive with complete donor chimerism, We conclude that fludarabine may be used in place of irradiation to augment the conditioning regimen of cyclophosphamide and anti-thymocyte globulin for alternative donor transplantation in children with SAA.
All Author(s) ListChan KW, Li CK, Worth LL, Chik KW, Jeha S, Shing MK, Yuen PM
Journal nameBone Marrow Transplantation
Volume Number27
Issue Number2
Pages125 - 128
LanguagesEnglish-United Kingdom
Keywordsallogeneic stem cell transplantation; alternative donors; fludarabine; severe aplastic anemia
Web of Science Subject CategoriesBiophysics; Hematology; HEMATOLOGY; Immunology; IMMUNOLOGY; Oncology; ONCOLOGY; Transplantation; TRANSPLANTATION

Last updated on 2020-27-11 at 01:56