Successful second cord blood transplantation using fludarabine and cyclophosphamide as a preparative regimen for graft rejection following reduced-intensity cord blood transplantation

Abstract

Successful second cord blood transplantation using fludarabine and cyclophosphamide as a preparative regimen for graft rejection following reduced-intensity cord blood transplantation

Unrelated cord blood transplantation in pediatric patients: a report from Saudi Arabia

“…25,26 Second cord blood transplants are associated with a high incidence of regimen-related morbidity and mortality even with reduced-intensity regimens. [27][28][29][30] In this report, seven of our patients underwent second cord blood transplants and six of them engrafted successfully as shown by STR studies. Toxicity, however, was a major complication as four of our patients died of regimen-related toxicity (two had RIC, one had ATG only and one had myeloablative conditioning).…”

Early identification and management of graft failure after unrelated cord blood transplantation

“…Two recent reports also utilized early chimerism results to decide on early second UCBT. 8,9 Our experience demonstrates that second unrelated donor UCBT is a viable option in the management of primary GF following UCBT, and it should be considered early. With experience we have been able to perform the rescue procedure earlier (first five cases: median 84 days, last four cases: median 55 days).…”

“…Recent reports do indicate that another reducedintensity regimen can lead to successful engraftment. [7][8][9] Infectious complications accounted for most of the early deaths after second transplants. 12,13,15,17 Our patients did not encounter a high incidence of early infections, which might be the result of prompt second UCBT.…”

“…There are several case reports successfully using this approach for the management of GF. [7][8][9][10][11] Treatment-related mortality has generally been high after second allogeneic transplants. [12][13][14][15][16][17] Prior cytoreduction and prolonged pancytopenia adversely affect the recipient's tolerance to further treatment.…”

High incidence of graft failure in unrelated cord blood transplantation using a reduced-intensity preparative regimen consisting of fludarabine and melphalan

“…Patients 6 and 7 have been described in previous case reports. 5,6 The preparative regimen included fludarabine 25 mg/m 2 on days À6 to À2 and melphalan 90 mg/m 2 on days À3 to À2. graft-versus-host disease (GVHD) prophylaxis consisted of a continuous infusion of tacrolimus 0.02 mg/kg from day À1 until the patients could tolerate oral administration and short-term methotrexate (MTX) (10 mg/m 2 on day 1, 7 mg/m 2 on day 3 and 7 mg/m 2 on day 6).…”