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Fludarabine‐based reduced intensity conditioning regimens for allogeneic hematopoietic stem cell transplantation in patients with aplastic anemia and fungal infections
Author(s) -
George Biju,
Mathews Vikram,
Viswabandya Auro,
Srivastava Alok,
Chandy Mammen
Publication year - 2009
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/j.1399-0012.2008.00909.x
Subject(s) - medicine , fludarabine , aplastic anemia , transplantation , cyclophosphamide , surgery , hematopoietic stem cell transplantation , anemia , stem cell , gastroenterology , chemotherapy , bone marrow , biology , genetics
Eighteen patients (12 men and 6 women) with aplastic anemia and active fungal infections (10 proven/probable; 8 possible) underwent stem cell transplantation using fludarabine combined with cyclophosphamide or total body irradiation. Peripheral blood stem cells (PBSC) were the main graft source and a combination of cyclosporine with either methotrexate or methylprednisolone was used for graft versus host disease prophylaxis. Fourteen patients (77.8%) achieved neutrophil engraftment after a median time of 11 d, while four died of fungal sepsis. Resolution of fungal infection occurred in 60% of patients with proven/probable infections and in 100% with possible fungal infections. At a median follow up of 30 months, 11 patients (61.1%) were alive and well. Fludarabine‐based conditioning regimens with PBSC transplantation can be used successfully in patients with aplastic anemia and fungal infections.