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Allografting

Salvage transplantation for allograft failure using fludarabine and alemtuzumab as conditioning regimen

Bone Marrow Transplantation volume 43, pages 477–480 (2009)Cite this article

Abstract

Graft failure after allogeneic blood or marrow transplantation, although generally uncommon, can be a devastating complication. This report includes the outcome of nine patients who received a salvage transplant for failure to engraft after one (n=8) or 2 (n=1) prior transplants. Eight patients received allografts from the original donor. All received fludarabine 30 mg/m2 i.v. and alemtuzumab 20 mg i.v. daily from days −6 to −2. Daily CYA was begun on day −2, and the allograft was infused on day 0. The therapy was well tolerated with low toxicity, and all nine patients engrafted, recovering neutrophils at a median of 12 days after transplant. Four patients died: two of relapse, one of a fungal infection in the setting of GVHD and one of multiple sclerosis. The combination of fludarabine and alemtuzumab is an effective and well-tolerated salvage conditioning regimen for patients who experience graft failure after blood or marrow transplants.

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Acknowledgements

This research was supported in part by the Grant CA15396 from the NIH. This study was presented in part at the 2008 Meeting of the American Society for Blood and Marrow Transplantation in San Diego, CA, USA.

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Authors and Affiliations

  1. Department of Oncology, ‘George W. Santos’ Bone Marrow Transplant Service, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins and The Johns Hopkins University School of Medicine, Baltimore, MD, USA

    J Bolaños-Meade, L Luznik, M Muth, W H Matsui, C A Huff, B D Smith, M Y Levy, Y L Kasamon, L J Swinnen, J D Powell, R A Brodsky, R F Ambinder, R J Jones & E J Fuchs

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  1. J Bolaños-Meade
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Correspondence to J Bolaños-Meade.

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Bolaños-Meade, J., Luznik, L., Muth, M. et al. Salvage transplantation for allograft failure using fludarabine and alemtuzumab as conditioning regimen. Bone Marrow Transplant 43, 477–480 (2009). https://doi.org/10.1038/bmt.2008.353

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