Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Letter to the Editor
  • Published:

Severe regimen-related toxicity of second transplantation for graft failure following reduced-intensity cord blood transplantation in an adult patient

Bone Marrow Transplantation volume 37, pages 787–788 (2006)Cite this article

Graft failure represents a serious complication after allogeneic stem cell transplantation (allo-SCT).1 Such failure comprises two clinical entities: primary graft failure and graft rejection.2 Three treatment options are available for primary graft failure: administration of hematopoietic growth factor; booster infusion of donor hematopoietic stem cells; or infusion of previously harvested autologous hematopoietic stem cells.1 In the management of graft rejection, further immunosuppressive conditioning is necessary before second infusion of hematopoietic stem cells.1

Some recent reports have demonstrated the feasibility of cord blood transplantation (CBT) using reduced-intensity regimens (RI-CBT) for adult patients with advanced hematological disease.3, 4 Graft failure is a significant complication associated with high mortality in both RI-CBT.5 Narimatsu et al.5 reported that nine of 123 patients developed graft failure and four patients underwent second RI-CBT and developed severe regimen-related toxicities (RRTs) following a conditioning regimen of fludarabine 125 mg/m2, either melphalan 80 mg/m2 or busulfan 8 mg/kg, and 2–4 Gy total body irradiation (TBI).

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

References

  1. Georges G, Storb R . Failure of sustained engraftment: clinical manifestations and treatment. In: Atkinson K (ed). Clinical Bone Marrow and Blood Stem Cell Transplantation, 3rd edn. Cambridge University Press: Cambridge, UK, 2000, pp 1088–1188.

    Google Scholar 

  2. Hows JM . Mechanisms of graft failure after human marrow transplantation: a review. Immunol Lett 1991; 29: 77–80.

    Article  CAS  PubMed  Google Scholar 

  3. Miyakoshi S, Yuji K, Kami M, Kusumi E, Kishi Y, Kobayashi K et al. Successful engraftment after reduced-intensity umbilical cord blood transplantation for adult patients with advanced hematological diseases. Clin Cancer Res 2004; 10: 3586–3592.

    Article  PubMed  Google Scholar 

  4. Barker JN, Weisdorf DJ, DeFor TE, Blazar BR, Miller JS, Wagner JE . Rapid and complete donor chimerism in adult recipients of unrelated donor umbilical cord blood transplantation after reduced-intensity conditioning. Blood 2003; 102: 1915–1919.

    Article  CAS  PubMed  Google Scholar 

  5. Narimatsu H, Kami M, Miyakoshi S, Murashige N, Yuji K, Hamaki T et al. Graft failure following reduced-intensity cord blood transplantation for adult patients. Br J Haematol 2006; 132: 36–41.

    Article  PubMed  Google Scholar 

  6. Storb R, Weiden PL, Sullivan KM, Appelbaum FR, Beatty P, Buckner CD et al. Second marrow transplants in patients with aplastic anemia rejecting the first graft: use of a conditioning regimen including cyclophosphamide and antithymocyte globulin. Blood 1987; 70: 116–121.

    CAS  PubMed  Google Scholar 

  7. Staba SL, Escolar ML, Poe M, Kim Y, Martin PL, Szabolcs P et al. Cord-blood transplants from unrelated donors in patients with Hurler's syndrome. N Engl J Med 2004; 350: 1960–1969.

    Article  CAS  PubMed  Google Scholar 

  8. Davies SM, Weisdorf DJ, Haake RJ, Kersey JH, McGlave PB, Ramsay NK et al. Second infusion of bone marrow for treatment of graft failure after allogeneic bone marrow transplantation. Bone Marrow Transplant 1994; 14: 73–77.

    CAS  PubMed  Google Scholar 

  9. Wagner JE, Barker JN, DeFor TE, Baker KS, Blazar BR, Eide C et al. Transplantation of unrelated donor umbilical cord blood in 102 patients with malignant and nonmalignant diseases: influence of CD34 cell dose and HLA disparity on treatment-related mortality and survival. Blood 2002; 100: 1611–1618.

    CAS  PubMed  Google Scholar 

  10. Petersdorf EW, Longton GM, Anasetti C, Mickelson EM, McKinney SK, Smith AG et al. Association of HLA-C disparity with graft failure after marrow transplantation from unrelated donors. Blood 1997; 89: 1818–1823.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Hematology and Oncology, JA Aichi Showa Hospital, Konan, Japan

    K Shimada, H Narimatsu, Y Morishita, A Kohno, S Saito & Y Kato

  2. Department of Hematology, Toyohashi Municipal Hospital, Toyohashi, Japan

    H Narimatsu

Authors
  1. K Shimada
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. H Narimatsu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Y Morishita
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. A Kohno
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. S Saito
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Y Kato
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Shimada, K., Narimatsu, H., Morishita, Y. et al. Severe regimen-related toxicity of second transplantation for graft failure following reduced-intensity cord blood transplantation in an adult patient. Bone Marrow Transplant 37, 787–788 (2006). https://doi.org/10.1038/sj.bmt.1705312

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.bmt.1705312

This article is cited by

Search

Advanced search

Quick links