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Haploidentical hematopoietic stem cell transplantation in a myelofibrosis patient with primary graft failure

Cristina Tecchio, Angelo Andreini, Claudio Costantini, Alberto Zamò, Donata de Sabata, Fiorenza Aprili, Roberta Galavotti, Emanuele Guardalben, Fabio Benedetti
  • Cristina Tecchio
    Section of Hematology and Bone Marrow Transplant Unit, Department of Medicine, University of Verona, Italy | cristina.tecchio@univr.it
  • Angelo Andreini
    Section of Hematology and Bone Marrow Transplant Unit, Department of Medicine, University of Verona, Italy
  • Claudio Costantini
    Section of Hematology and Bone Marrow Transplant Unit, Department of Medicine, University of Verona, Italy
  • Alberto Zamò
    Section of Pathology and Diagnostics, Department of Pathology, University of Verona, Italy
  • Donata de Sabata
    Section of Hematology and Bone Marrow Transplant Unit, Department of Medicine, University of Verona, Italy
  • Fiorenza Aprili
    Clinical Biochemistry Laboratory, Department of Life and Reproduction Sciences, University of Verona, Italy
  • Roberta Galavotti
    Section of Biology and Genetics, Department of Mother and Child, University of Verona, Italy
  • Emanuele Guardalben
    Section of Hematology and Bone Marrow Transplant Unit, Department of Medicine, University of Verona, Italy
  • Fabio Benedetti
    Section of Hematology and Bone Marrow Transplant Unit, Department of Medicine, University of Verona, Italy

Abstract

The prognosis of patients affected by myelofibrosis (MF) is usually dismal and allogeneic hematopoietic stem cell transplantation (HSCT) remains the only cure. The number of HSCTs in MF patients has recently increased. However, a major obstacle is still represented by primary graft failure (PGF). Currently there are no definitive guidelines for the treatment of PGF and a second HSCT can be performed only when an allogeneic donor is rapidly available. Herein we report on a MF patient with PGF after an unrelated HSCT, who was rescued by a non-myeloablative, unmanipulated, haploidentical HSCT that resulted in persistent engraftment and bone-marrow fibrosis regression, but not in a long-term disease control. Based on this experience we briefly review the role of different conditioning regimens and hematopoietic stem cell sources in the setting of HSCT for MF patients with PGF. The role of haploidentical donors in MF patients lacking HLAmatched relatives is also discussed.

Keywords

primary graft failure, haploidentical hematopoietic stem cell transplantation, myelofibrosis

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Submitted: 2017-02-13 16:27:34
Published: 2018-01-03 08:16:24
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Copyright (c) 2017 Cristina Tecchio, Angelo Andreini, Claudio Costantini, Alberto Zamò, Donata de Sabata, Fiorenza Aprili, Roberta Galavotti, Emanuele Guardalben, Fabio Benedetti

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