MT2013-06C : Treatment of graft Failure after HSCT

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Inclusion Criteria:
Patients with primary or secondary graft failure, as defined below, may receive a second transplant: Primary graft failure is defined as not achieving an ANC ≥0.5x10^9/L for three consecutive days by day 35 - 42 following the first transplant. Secondary graft failure is defined as achieving an ANC ≥0.5x10^9/L for three consecutive days by day 35 - 42, but subsequently drops below 0.5x10^9/L without recovery. Loss of chimerism is defined as achieving an ANC ≥0.5x10^9/L for three consecutive, but with less than 10% CD15+ donor cells in the marrow or peripheral blood. Recipients should have acceptable organ function defined as: Renal: creatinine < 2.0 (adults) and creatinine clearance > 30. For creatinine clearance < 70, consultation with a BMT pharmacist is necessary for chemotherapy dose adjustments. Hepatic: bilirubin, AST/ALT, ALP < 10 x upper limit of normal Cardiac: left ventricular ejection fraction > 40%
Exclusion Criteria:
Uncontrolled infection at the time of transplant. Patients with Fanconi Anemia or other DNA breakage syndromes.

Drug: Cyclophosphamide, Drug: Fludarabine, Biological: Hematopoietic stem cell infusion, Radiation: Total Body Irradiation

Primary Graft Failure, Secondary Graft Failure

Clinics and Surgery Center (CSC)

Timothy Krepski -
Troy Lund
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