¹Division of Stem Cell Therapy, Department of Medicine, Duke University Medical Center, Durham, NC, USA

Correspondence: Dr DA Rizzieri, Adult Bone Marrow and Stem Cell Transplant Program, Duke University Medical Center, 2400 Pratt Street, Suite 1100, Box 3961, Duke North Pavilion, Durham, NC 27710, USA. E-mail: rizzi003@mc.duke.edu

Received 11 June 2007; Revised 28 August 2007; Accepted 28 August 2007; Published online 5 November 2007.

Abstract

Following initial graft rejection, a second attempt at allogeneic immunotherapy is often contemplated, but data on the success is limited. We therefore report on 11 patients with hematologic malignancies, renal cell cancer or marrow failure who underwent a second reduced-intensity regimen for primary or secondary graft failure. Nine of the 11 patients initially engrafted with the second attempt including two of four who used the same donor. One of the patients engrafted after the third attempt using a different donor and conditioning regimen. There were two treatment-related deaths. Four patients died from progressive disease 1–9 months after the second transplant. Two patients are still in recovery phase less than 1 year from the second transplant. Long-term remission is possible and three patients are alive in complete remission.