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Case Series Using Salvage Haplo-Identical Stem Cells for Secondary Transplantation

Title: Case Series Using Salvage Haplo-Identical Stem Cells for Secondary Transplantation
Authors: Alexandra Ionete; Zsofia Varady; Orsolya Szegedi; Daniel Coriu
Source: Medicina, Vol 59, Iss 6, p 1077 (2023)
Publisher Information: MDPI AG
Publication Year: 2023
Collection: Directory of Open Access Journals: DOAJ Articles
Subject Terms: haploidentical transplant; bone marrow transplant; rejection of stem cell graft; Medicine (General); R5-920
Description: In order to expand the donor pool and accessibility of the transplant procedure, it was necessary to introduce haplo-identical stem cell transplants in the Fundeni Clinical Institute from 2015. Even if the Romanian population is an ethnically compact white population, many of the patients referred for bone marrow transplant lack a suitable donor. Hematopoietic stem cell transplant from a haplo-identical donor is an alternative option for those patients without an HLA (Human Leucocyte Antigen)-matched donor (sibling or matched unrelated). This procedure was used also as a salvage option for those who experienced engraftment failure or the rejection of the first stem cell graft. In this case series, we present three such cases, with a haplo-transplant used as a salvage protocol (after an engraftment failure or rejection of the first transplanted cells). The patients we present were diagnosed with AML (acute myeloid leukemia) with MDS (myelodysplastic syndrome), MDS—RAEB 2 (myelodysplastic syndrome—refractory anemia with excess blasts 2), and SAA (severe aplastic anemia). In two of the three cases, the engraftment failure may have been due to the conditioning Fludarabine/Busulfan/Cyclophosphamide (Flu/Bu/CFA) used, combined with marrow grafts. In all three cases, the second transplant was of haplo-identical peripheral blood stem cells using Melphalan/Fludarabine (Mel/Flu) conditioning, the cells engrafted properly and the patients experienced complete chimerism, and two of them are alive with an excellent quality of life.
Document Type: article in journal/newspaper
Language: English
Relation: https://www.mdpi.com/1648-9144/59/6/1077; https://doaj.org/toc/1010-660X; https://doaj.org/toc/1648-9144; https://doaj.org/article/2596481358c0488abc9846e7eb1fc5fa
DOI: 10.3390/medicina59061077
Availability: https://doi.org/10.3390/medicina59061077; https://doaj.org/article/2596481358c0488abc9846e7eb1fc5fa
Accession Number: edsbas.897373AB
Database: BASE