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Feasibility of second hematopoietic stem cell transplantation using reduced-intensity conditioning with fludarabine and melphalan after a failed autologous hematopoietic stem cell transplantation

Authors
 J.Y. Hong  ;  M.K. Choi  ;  D.H. Kim  ;  S.J. Kim  ;  K. Kim  ;  W.S. Kim  ;  C.W. Chung  ;  H.O. Kim  ;  Y.H. Min  ;  J.H. Jang 
Citation
 TRANSPLANTATION PROCEEDINGS, Vol.42(9) : 3723-3728, 2010 
Journal Title
 TRANSPLANTATION PROCEEDINGS 
ISSN
 0041-1345 
Issue Date
2010
MeSH
Adult ; Disease-Free Survival ; Feasibility Studies ; Female ; Graft vs Host Disease/etiology ; Hematopoietic Stem Cell Transplantation*/adverse effects ; Hematopoietic Stem Cell Transplantation*/mortality ; Humans ; Kaplan-Meier Estimate ; Leukemia, Myeloid, Acute/mortality ; Leukemia, Myeloid, Acute/surgery* ; Lymphoma, Non-Hodgkin/mortality ; Lymphoma, Non-Hodgkin/surgery* ; Male ; Melphalan/adverse effects ; Melphalan/therapeutic use* ; Middle Aged ; Multiple Myeloma/mortality ; Multiple Myeloma/surgery* ; Myeloablative Agonists/adverse effects ; Myeloablative Agonists/therapeutic use* ; Recurrence ; Reoperation ; Republic of Korea ; Retrospective Studies ; Salvage Therapy ; Survival Rate ; Time Factors ; Transplantation Chimera ; Transplantation Conditioning/adverse effects ; Transplantation Conditioning/methods* ; Transplantation, Autologous ; Treatment Failure ; Vidarabine/adverse effects ; Vidarabine/analogs & derivatives* ; Vidarabine/therapeutic use
Abstract
This study was performed to determine the feasibility of second hematopoietic stem cell transplantation (HSCT) using reduced-intensity conditioning (RIC) with fludarabine and melphalan in patients with relapsed hematologic malignancies after a prior autologous HSCT. Twelve patients (multiple myeloma [n = 7], non-Hodgkin lymphoma [n = 3], and acute myeloid leukemia [n = 2] received allogeneic HSCT using RIC with fludarabine (25 mg/m(2) for 5 days) and melphalan (140 mg/m(2) for 1 day) after a failed autologous HSCT. The graft-versus-host disease (GVHD) prophylaxis consisted of cyclosporine plus a minidose of methotrexate. All patients achieved a neutrophil and platelet engraftment in a median 13.5 days and 17.5 days, respectively. The transplant-related mortality was 2 patients (16.7%). Grade II-IV acute GVHD and chronic extensive GVHD were noted in 4 (33.3%) and 1 patient (11.1%), respectively. Over a median follow-up duration of 376 days, 5 patients were alive without evidence of disease. The estimated nonrelapse mortality at 1 year was 28.4%. The estimated overall survival rate at 1 year was 58.3%, and the estimated event-free survival rate at 1 year was 41.7%. Allogeneic HSCT using RIC with fludarabine and melphalan appears to be feasible for a second HSCT in patients with relapsed hematologic malignancies after a failed autologous HSCT
Full Text
http://www.sciencedirect.com/science/article/pii/S004113451001331X
DOI
10.1016/j.transproceed.2010.09.005
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Min, Yoo Hong(민유홍) ORCID logo https://orcid.org/0000-0001-8542-9583
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/103151
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