Salvage Allogeneic Hematopoietic Cell Transplantation with Fludarabine and Low-Dose Total Body Irradiation after Rejection of First Allografts Boglarka.

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Low-dose total body irradiation (TBI) and fludarabine followed by hematopoietic cell transplantation (HCT) from HLA-matched or mismatched unrelated donors.

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Salvage Allogeneic Hematopoietic Cell Transplantation with Fludarabine and Low-Dose Total Body Irradiation after Rejection of First Allografts Boglarka Gyurkocza, Thai M. Cao, Rainer F. Storb, Thoralf Lange, Wendy Leisenring, Georg N. Franke, Mohamed Sorror, Richard Hoppe, David G. Maloney, Robert S. Negrin, Judith A. Shizuru, Brenda M. Sandmaier Biology of Blood and Marrow Transplantation Volume 15, Issue 10, Pages 1314-1322 (October 2009) DOI: 10.1016/j.bbmt.2009.06.011 Copyright © 2009 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 1 Outcomes of salvage HCT. Neutrophil engraftment (A). Thirty-three of 38 patients had sustained engraftment (probability of engraftment: 0.87; 95% CI: 0.74, 0.95). The median time to neutrophil engraftment was 15 (range: 9-42) days. Survival (B). The 2- and 4-year estimated probabilities of survival were 0.49 (95% CI: 0.31, 0.66) and 0.42 (95% CI: 0.23, 0.61), respectively. NRM (C). The 2-year estimated probability of NRM was 0.24 (95% CI: 0.11, 0.41). Relapse/progression (D). The estimated probability of relapse/progression at 2 years was 0.36 (95% CI: 0.20, 0.52). The dashed lines represent 95% CI. Biology of Blood and Marrow Transplantation 2009 15, 1314-1322DOI: (10.1016/j.bbmt.2009.06.011) Copyright © 2009 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 2 GVHD. Grades II-IV aGVHD (A). The cumulative incidence of grades II-IV aGVHD at day 100 was 0.42 (95% CI: 0.26, 0.57). The cumulative incidences of grade III and grade IV aGVHD were 0.05, each (95% CI: 0.009, 016). Moderate-severe cGVHD (B). The cumulative incidence of moderate-severe cGVHD at 2 years was 0.41 (95% CI: 0.25, 0.57). The dashed lines represent 95% CI. Biology of Blood and Marrow Transplantation 2009 15, 1314-1322DOI: (10.1016/j.bbmt.2009.06.011) Copyright © 2009 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 3 Impact of donor type (A), using same versus different donor (B), TBI dose (C), and HCT-CI score (D) for OS. Biology of Blood and Marrow Transplantation 2009 15, 1314-1322DOI: (10.1016/j.bbmt.2009.06.011) Copyright © 2009 American Society for Blood and Marrow Transplantation Terms and Conditions