Addition of High-Dose Cytarabine to Fludarabine-Based Conditioning for Hematopoietic Stem Cell Transplantation for Treating Fanconi Anemia Patients with Advanced Myeloid Malignancy: A Single-Center Experience and Literature Review

Abstract

The complication of Fanconi anemia (FA) with acute leukemia is rare and challenging to treat because of high relapse rates, despite the improved outcome of hematopoietic stem cell transplantation with fludarabine-based conditioning for treating FA patients with hematological abnormalities. We added high-dose cytarabine to fludarabine-based conditioning to promote an enhanced antitumor effect and successfully subjected 4 patients with FA, including 3 with acute leukemia, to hematopoietic stem cell transplantation. All patients remain alive without treatment-related mortality or evidence of disease. Adding high-dose cytarabine to fludarabine-based conditioning may be tolerable and effective for treating FA patients with acute leukemia.

How I manage patients with Fanconi anaemia

“…Five of 8 patients are alive after transplant. A similar strategy has been used by a Japanese group who added high dose cytarabine (2 g/m 2 per day for 5 days) to a Flu‐based conditioning regimen in 4 patients (3 with AML and one with 12% blast MDS) who are all alive with no evidence of disease after a follow‐up of 8 months to 14 years (Aoki et al , ).…”