Increased early mortality after fludarabine and melphalan conditioning with peripheral blood grafts in haploidentical hematopoietic cell transplantation with post-transplant cyclophosphamide
Autor: | David A. Russler-Germain, Ramzi Abboud, Thomas J Fountaine, Eric Huselton, Jeffrey R. Andolina, Luke Eastburg, John F. DiPersio |
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Rok vydání: | 2021 |
Předmět: |
Oncology
Melphalan Cancer Research medicine.medical_specialty Transplantation Conditioning Cyclophosphamide Graft vs Host Disease Internal medicine Humans Medicine Retrospective Studies business.industry Hematopoietic Stem Cell Transplantation Hematology medicine.disease Peripheral blood Fludarabine Transplantation Cytokine release syndrome surgical procedures operative medicine.anatomical_structure Conditioning Bone marrow business Vidarabine medicine.drug |
Zdroj: | Leukemia & Lymphoma. 63:222-226 |
ISSN: | 1029-2403 1042-8194 |
Popis: | Due to the evolving use of haploidentical donor grafts in hematopoietic cell transplantation, there is increased need to better understand the risks and benefits of using bone marrow versus peripheral blood grafts, as well as how specific pre-transplantation conditioning regimens impact patient safety and treatment outcomes. We performed a retrospective analysis of 38 patients at two centers who underwent haploidentical hematopoietic cell transplantation using fludarabine plus melphalan-based conditioning regimens with post-transplant cyclophosphamide and peripheral blood donor grafts. We observed an unexpectedly high rate of early non-relapse mortality and severe cytokine release syndrome. The poor outcomes with 1-year overall survival of 34%, disease-free survival of 29%, and non-relapse mortality of 34% motivate us to reconsider the appropriateness of the combination of fludarabine and melphalan conditioning with T-cell replete peripheral blood grafts in the setting of haploidentical hematopoietic cell transplant with post-transplant cyclophosphamide. |
Databáze: | OpenAIRE |
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