2006, Number 1
<< Back Next >>
Rev Invest Clin 2006; 58 (1)
Second allogeneic peripheral blood stem cell transplants with reduced-intensity conditioning
Ruiz-Argüelles GJ, Gomez-Almaguer D, Tarin-Arzaga LC, Morales-Toquero A, Cantu-Rodriguez OG, Manzano C
Language: English
References: 21
Page: 34-38
PDF size: 60.31 Kb.
ABSTRACT
In two institutions in México, twelve patients were given a second allogeneic stem cell transplantation, using the “Mexican” non-myeloablative preparative regimen. Eight had a malignant condition (six acute leukemias, one myelofibrosis and one myelodysplasia), eleven individuals were allografted twice from the same donor and in one case, cells from two different umbilical cords were used. The median time to conduct the second allograft after the first one was 6 months (range 1-41). The five patients who failed to engraft after the first transplant failed also to engraft after the second one; all of them had been heavily transfused. Only three patients were successfully rescued with the second transplant, two with acute leukemia and one with aplastic anemia. Seven patients are alive 10-41 months (median 35) after the second transplant, but only three (25%) remain disease-free. The 52-month overall survival (SV) of the patients is 58%, whereas the median overall SV has not been reached, being above 52 months. Conducting a second allograft may be useful to rescue some individuals relapsing after a first hematopoietic allotransplant.
REFERENCES
Thomas ED. Hematopoietic stem cell transplantation. Sci Am 1995; 272: 38.
Eapen M, Giralt SA, Horowitz MM, Klein JP, Wagner JE, Zhang MJ, et al. Litzow MR, deLima M. Second transplant for acute and leukemia relapsing after first HLA-identical sibling transplant. Bone Marrow Transplal 2004; 34: 721-7.
Guardiola P, Kuentz M, Garban F, Blaise D, Reiffers J, Attal M, et al. Second early allogeneic stem cell transplantations for graft failure in acute leukemia, chronic myeloid leukemia and aplastic anaemia. Br J Haem 2000; 111: 292-302.
Martino R, Caballero MD, De la Serna J, Díez-Martín JL, Urbano-Ispízua A, Tomás JF, et al. Low transplant-related mortality after second allogeneic peripheral blood stem cell transplant with reduced-intensity conditioning in adult patients who have failed a prior autologous transplant. Bone Marrow Transpl 2002; 30: 63-8.
Ruiz-Argüelles GJ, Gómez-Almaguer D. Braking dogmata to help patients: Non-myeloablative hematopoietic stem cell transplantation. Expert Opin Biol Ther 2004; 4: 1693-9.
Ruiz-Argüelles GJ, Ruiz-Argüelles A, Pérez-Romano B, Marín-López A, Delgado-Lamas JL. Non-cryopreserved peripheral blood stem cells autotransplants for hematological malignancies can be performed entirely on an outpatient basis. Am J Hematol 1998, 58: 161-4.
Ruiz-Argüelles GJ, López-Martínez B, Manzano C, Gómez-Rangel JD, Lobato-Mendizábal E. Significance of one human leukocyte antigen mismatch on outcome of non-myeloablative allogeneic stem cell transplantation from related donors using the Mexican schedule. Bone Marrow Transpl 2005; 35: 335-9.
Ruiz-Argüelles GJ, Gómez-Rangel JD, Ponce-de-León S, González-Déctor L, Reyes-Núñez V, Garcés-Eisele J. The Mexican schedule to conduct allogeneic stem cell transplantation is related to a low risk of cytomegalovirus reactivation and disease. Am J Hematol 2004; 75; 200-4.
Gómez-Almaguer D, Ruiz-Argüelles GJ, Ruiz-Argüelles A, González-Llano O, Cantú OE, Hernández NE. Hematopoietic stem cell allografts using a non-myeloablative conditioning regimen can be safely performed on an outpatient basis. Bone Marrow Transpl 2000; 25: 131-3.
Ruiz-Argüelles GJ, Gómez-Almaguer D, Ruiz-Argüelles A, González-Llano O, Cantú OG, Jaime Pérez JC. Results of an outpatient-based stem cell allotransplant program using nonmyeloablative conditioning regimens. Am J Hematol 2001; 66: 241-4.
Ruiz-Argüelles GJ. Outpatient programs of myeloablative chemotherapy, autologous and allogeneic bone marrow transplantation. Haematologica 2000; 85: 1233-4.
Ruiz-Argüelles GJ, Gómez-Almaguer D, Gómez Rangel JD, Vela-Ojeda J, Cantú-Rodríguez OG, Jaime-Pérez JC, et al. Allogeneic hematopoietic stem cell transplantation with nonmyeloablative conditioning in patients wth acute leukemia eligible for conventional allografting: a prospective study. Leukemia Lymphoma 2004; 45: 1191-5.
Gómez-Almaguer D, Ruiz-Argüelles GJ, Tarín-Arzaga LC, González-Llano O, Jaime-Pérez JC, López-Martínez B, et al. Reduced-intensity stem cell transplantation in children and adolescents: The Mexican experience. Biol Blood Marrow Transpl 2003, 9: 157-61.
Ruiz-Argüelles GJ. Allogeneic stem cell transplantation using non-myeloablative conditioning regimens: Results of “the Mexican approach”. Int J Hematol 2002; 76(Suppl. 1): 376-9.
Ruiz-Argüelles GJ, Gómez-Almaguer D, López-Martínez B, Cantú-Rodríguez OG, Jaime-Pérez JC, González-Llano O. Results of an allogeneic non-myeloablative stem cell transplantation program in patients with chronic myelogenous leukemia. Haematologica 2002; 87: 894-6.
Kessinger A, Armitage JO, Landmark JD, Smith DM, Weisenburger DD. Autologous peripheral hematopoietic stem cell transplantation restores hemopoietic function following marrow ablative therapy. Blood 1988; 71: 723-7.
Ruiz-Argüelles A. Flow cytometry in the clinical laboratory. Principles, applications and problems. Ann Biol Clin 1992; 50:735-43
Ruiz-Argüelles A, Orfao A. Caracterización y evaluación de células totipotenciales en sangre periférica y médula ósea. In: Ruiz-Argüelles GJ, San-Miguel JF (eds.). Actualización en leucemias. México City: Editorial Médica Panamericana; 1996, p. 79-82.
Jaime-Pérez JC, Ruiz-Argüelles GJ, Gómez-Almaguer D. Haematopoietic stem cell transplantation to treat aplastic anemia. Expert Opin Biol Ther 2005; 5: 617-26.
Gómez-Almaguer D, Vela-Ojeda J, Jaime-Pérez JC, Gutiérrez-Aguirre CH, Cantú-Rodríguez OG, Sobrevilla-Calvo P, et al. Allografting in patients with severe aplastic anemia using peripheral blood stem cells and a fludarabine-based conditoning regimen: The Mexican Experience. Am J Hematol 2006 (in the press).
Ruiz-Argüelles GJ, Gómez-Rangel D, Sánchez-Anzaldo J, Ruiz-Argüelles A, Porras-Ramírez G, Luis-López A. Trasplante de células de cordón umbilical: informe de dos casos. Medicina Univ 2002; 4: 233-5.