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For patients with disease relapse or graft failure after allogeneic hematopoietic cell transplantation (HCT), there are few treatment options and survival rates are exceedingly low. Because of the unacceptably high risk of transplantation-related mortality, second allogeneic HCTs are often not considered. Herein, we report the outcomes of 23 patients (median age, 33 years) undergoing a second allogeneic transplantation with unrelated cord blood donor grafts between 2006 and 2013. Indications for second HCT were relapse (n = 19), graft failure (n = 3), and donor-derived myelodysplastic syndrome (n = 1). Ten patients received reduced-intensity conditioning and 13 patients received either myeloablative (MAC) or middle-intensity (MIDI) conditioning. Twenty patients received a double cord blood transplantation. All patients engrafted at a median of 22 days (range, day 6 to 49). Death before day 100 occurred in 5 patients. Overall disease-free survival (DFS), treatment-related mortality, and relapse at 2 years were 31

作者:Rachel B, Salit;Filippo, Milano;Colleen, Delaney

来源:Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation 2016 年 22卷 2期

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作者:
Rachel B, Salit;Filippo, Milano;Colleen, Delaney
来源:
Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation 2016 年 22卷 2期
标签:
Donor source Second allogeneic transplantation Umbilical cord blood transplantation
For patients with disease relapse or graft failure after allogeneic hematopoietic cell transplantation (HCT), there are few treatment options and survival rates are exceedingly low. Because of the unacceptably high risk of transplantation-related mortality, second allogeneic HCTs are often not considered. Herein, we report the outcomes of 23 patients (median age, 33 years) undergoing a second allogeneic transplantation with unrelated cord blood donor grafts between 2006 and 2013. Indications for second HCT were relapse (n = 19), graft failure (n = 3), and donor-derived myelodysplastic syndrome (n = 1). Ten patients received reduced-intensity conditioning and 13 patients received either myeloablative (MAC) or middle-intensity (MIDI) conditioning. Twenty patients received a double cord blood transplantation. All patients engrafted at a median of 22 days (range, day 6 to 49). Death before day 100 occurred in 5 patients. Overall disease-free survival (DFS), treatment-related mortality, and relapse at 2 years were 31