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Conditioning Regimens

Fludarabine, cyclophosphamide plus thymoglobulin conditioning regimen for unrelated bone marrow transplantation in severe aplastic anemia

Bone Marrow Transplantation volume 34, pages 939–943 (2004)Cite this article

Summary:

Antithymocyte globulin (ATG) has been used in severe aplastic anemia (SAA) as a part of the conditioning regimen. Among the many kinds of ATG preparations, thymoglobulin had been found to be more effective in preventing GVHD and rejection of organ transplants. As the fludarabine-based conditioning regimens without total body irradiation have been reported to be promising for bone marrow transplantation (BMT) from alternative donors in SAA, thymoglobulin was added to fludarabine and cyclophosphamide conditioning to reduce GVHD and to allow good engraftment in unrelated BMT. Five patients underwent BMT with cyclophosphamide (50 mg/kg once daily i.v. on days −9, −8, −7 and −6), fludarabine (30 mg/m2 once daily i.v. on days −5, −4, −3 and −2) and thymoglobulin (2.5 mg/kg once daily i.v. on days −3, −2 and −1) from HLA-matched unrelated donors. Complete donor type hematologic recovery was achieved in all patients. No serious complication occurred during BMT. Only one patient developed grade I acute GVHD resolved spontaneously. Except for one who had rupture of hepatic adenoma 78 days after BMT, all the other four patients are still alive with median 566 days. Fludarabine, cyclophosphamide plus thymoglobulin conditioning allows for the promising results of good engraftment, tolerable toxicity and minimal GVHD.

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Authors and Affiliations

  1. Department of Pediatrics, Division of Hematology/Oncology, Seoul National University College of Medicine, Seoul, Republic of Korea

    H Y Shin, H S Choi & H S Ahn

  2. Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea

    H Y Shin, H S Choi & H S Ahn

  3. Pediatric Oncology Branch, National Cancer Center, Gyeonggi-do, Republic of Korea

    H J Kang

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  1. H J Kang
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Correspondence to H Y Shin.

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Kang, H., Shin, H., Choi, H. et al. Fludarabine, cyclophosphamide plus thymoglobulin conditioning regimen for unrelated bone marrow transplantation in severe aplastic anemia. Bone Marrow Transplant 34, 939–943 (2004). https://doi.org/10.1038/sj.bmt.1704720

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