Contributions
Abstract: PB2485
Type: Publication Only
Background
Primary graft failure remains one the important causes of mortality and morbidity in cases of stem cell transplantation. We report on a case of Aplastic Anaemia where an immediate rescue haploidentical stem cell transplantation from a different donor resulted in a successful engraftment
Aims
To determine whether an immediate transplantation with repeat conditioning chemo-radiation therapy can result in a successful engraftment in a case of primary graft failure
Methods
A 3yr old male child was diagnosed to have Severe Aplastic Anemia. Unfortunately there were no matched sibling donors and hence a haploidentical transplant using his fathers stem cells was undertaken. He was conditioned with Fludarabine, Cyclophosphamide, ATG and TBI and Post Transplant Cyclophosphamide was used for GVHD prophylaxis
Unfortunately he failed to engraft, and at day +21 we undertook a second rescue haploidentical transplant for the primary graft failure. As he had rejected his fathers stem cells, we decided not to use father the second time around as a donor re-transplant him using his mother stem cells. Though he was profoundly neutropenic with a WBC count of 20, we decided to give him full repeat conditioning with the same protocol as we surmised that he still had a active immune system that had rejected the primary graft. Repeat conditioning using the same protocol was started from Day + 22 and mother’s stem cells was infused on Day +28.
Results
He engrafted successfully by Day +12 of the second transplant and though the transplant was complicated by a cutaneous fungal infection and CMV reactivation, child was discharged home with 100% donor engraftment.
Conclusion
A second haploidentical transplant using repeat conditioning can be used successfully in cases of primary graft failure.
Session topic: 23. Stem cell transplantation - Clinical
Keyword(s): Aplastic anemia, Haploidentical stem cell transplantation
Abstract: PB2485
Type: Publication Only
Background
Primary graft failure remains one the important causes of mortality and morbidity in cases of stem cell transplantation. We report on a case of Aplastic Anaemia where an immediate rescue haploidentical stem cell transplantation from a different donor resulted in a successful engraftment
Aims
To determine whether an immediate transplantation with repeat conditioning chemo-radiation therapy can result in a successful engraftment in a case of primary graft failure
Methods
A 3yr old male child was diagnosed to have Severe Aplastic Anemia. Unfortunately there were no matched sibling donors and hence a haploidentical transplant using his fathers stem cells was undertaken. He was conditioned with Fludarabine, Cyclophosphamide, ATG and TBI and Post Transplant Cyclophosphamide was used for GVHD prophylaxis
Unfortunately he failed to engraft, and at day +21 we undertook a second rescue haploidentical transplant for the primary graft failure. As he had rejected his fathers stem cells, we decided not to use father the second time around as a donor re-transplant him using his mother stem cells. Though he was profoundly neutropenic with a WBC count of 20, we decided to give him full repeat conditioning with the same protocol as we surmised that he still had a active immune system that had rejected the primary graft. Repeat conditioning using the same protocol was started from Day + 22 and mother’s stem cells was infused on Day +28.
Results
He engrafted successfully by Day +12 of the second transplant and though the transplant was complicated by a cutaneous fungal infection and CMV reactivation, child was discharged home with 100% donor engraftment.
Conclusion
A second haploidentical transplant using repeat conditioning can be used successfully in cases of primary graft failure.
Session topic: 23. Stem cell transplantation - Clinical
Keyword(s): Aplastic anemia, Haploidentical stem cell transplantation