Skip Navigation



Japanese Journal of Clinical Oncology Advance Access published online on January 19, 2006
Japanese Journal of Clinical Oncology, doi:10.1093/jjco/hyi211
This Article
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
36/1/46    most recent
hyi211v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Request Permissions
Google Scholar
Right arrow Articles by Rzepecki, P.
Right arrow Articles by Szczylik, C.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Rzepecki, P.
Right arrow Articles by Szczylik, C.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© 2006 Foundation for Promotion of Cancer Research
Received October 5, 2005
Accepted November 17, 2005

Original Article

Alemtuzumab, Fludarabine and Melphalan as a Conditioning Therapy in Severe Aplastic Anemia and Hypoplastic Myelodysplastic Syndrome--Single Center Experience

P. Rzepecki 1 *, T. Sarosiek 1, and C. Szczylik 1

1 Department of Clinical Oncology, BMT Unit, Central Clinical Hospital Ministry of National Defence, Warsaw, Poland

* To whom correspondence should be addressed.
P. Rzepecki, E-mail: piotr_rzepecki1{at}poczta.onet.pl


  Abstract

Background: Allogeneic hematopoietic stem cell transplantation is the treatment of choice in young patients with severe aplastic anemia. The main causes of failure after this procedure are graft versus host disease, infections and graft failure, often exacerbated by large numbers of transfusions and prolonged disease duration before transplant.

Methods: We report the results of allografting following conditioning with fludarabine, alemtuzumab and melphalan in: five patients with severe aplastic anemia and one with hypoplastic myelodysplastic syndrome. All patients had matched sibling donors. Source of hematopoietic stem cell was: bone marrow--2, blood--3, bone marrow and blood--1. The age of recipients was 18-26 years. Four patients received their graft as the first line therapy and two after failure of cyclosporine and antithymocyte globulin treatment. Number of transfused units including red blood cells and platelets before transplantation was 8-100 (median: 22) and 10-32 (median: 11), respectively. All donors and recipients were CMV-seropositive. Conditioning consisted of: alemtuzumab 30 mg/d (day -7 to -5), fludarabine 30 mg/m2 (days -7 to -3) and melphalan 140 mg/m2 at the day -2.

Results: The time to granulocytes and platelets recovery was 15 and 25 days, respectively. All patients achieved full donor chimerism on day +60. Only two patients needed ganciclovir as preemptive therapy. Recurrent parvovirus B19 infection with pure red cell aplasia and acute viral B hepatitis was observed in one case. Pure red cell aplasia was successfully treated with immunoglobulins and cyclosporine discontinuation. With a follow-up of 16-39 (median: 29) months all patients are alive, and neither graft failure nor graft versus host disease, or any no other severe complications, was observed.

Conclusions: Our study suggests that transplantation of hematopoietic stem cell using alemtuzumab, fludarabine and melphalan as a conditioning therapy is safe, inexpensive and effective treatment for patients with severe aplastic anemia, including multi-transfused adults having their disease for a long time.

Keywords: aplastic anemia; hypoplastic myelodysplastic syndrome; alemtuzumab; fludarabine.
Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.