Affiliation:
1. From the Unità Operativa Ematologia e Centro Trapianto di Midollo Osseo di Muraglia, Azienda Ospedale S. Salvatore di Pesaro, Pesaro, Italy; the Clinical Division, Fred Hutchinson Cancer Research Center, Seattle, WA; and the Mediterranean Institute of Hematology, Rome, Italy.
Abstract
Abstract
When prepared for transplantation with busulfan (BU) 14 mg/kg and cyclophosphamide (CY) 120 to 160 mg/kg, patients with thalassemia in risk class 3, aged younger than 17 years, who receive transplants from HLA-identical donors, had a 30% incidence of transplant rejection with recurrence of thalassemia. This, relatively poor, outcome was ascribed to insufficient immune suppression or to inadequate eradication of the thalassemic marrow, or both. In an attempt to enhance both immune suppression and eradication of the thalassemic clones, hydroxyurea, azathioprine, and fludarabine were added to the BU and CY. This regimen, called protocol 26, was applied to 33 consecutive patients with class 3 thalassemia aged younger than 17 years and was well tolerated with 93% survival. The incidence of recurrent thalassemia after the transplantation decreased from 30% to 8%. (Blood. 2004;104:1201-1203)
Publisher
American Society of Hematology
Subject
Cell Biology,Hematology,Immunology,Biochemistry
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