Journal
BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION
Volume 26, Issue 10, Pages 1900-1905Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.bbmt.2020.06.027
Keywords
Severe aplastic anemia; Alemtuzumab; FCC conditioning; Children
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Various reduced-intensity conditioning regimens are in use for allogeneic hematopoietic cell transplant (HSCT) in patients with idiopathic severe aplastic anemia (SAA). We describe the use of fludarabine, Campath, and low-dose cyclophosphamide (FCClow) conditioning in 15 children undergoing related or unrelated donor transplants. Total body irradiation (TBI) of 2 Gy was added for unrelated donor HSCT. At a median follow-up of 2.3 years, the failure-free survival was 100%, with low rates of infection and toxicity. There was no occurrence of grade III to IV acute graft-versus-host disease (GVHD). All patients had full donor myeloid chimerism post-HSCT, even with mixed chimerism in the T cell lineage. The absence of chronic GVHD and long-term stable mixed donor T cell chimerism confirms immune tolerance following FCClow (+/-TBI) conditioned transplantation in children with SAA. Crown Copyright (c) 2020 Published by Elsevier Inc. on behalf of the American Society for Transplantation and Cellular Therapy. All rights reserved.
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