Vol. 3, Issue 2 (2018)
Autologous peripheral stem cell transplantation after two-day fludarabine conditioning in patients with acute leukaemia
Author(s): Dairion Gatot, Ida Adhayanti, Tonny Wongso, Michelle Hendriani Djuang, Rezky Maulani Yusof, Herman Hariman
Abstract: Background: Autologous stem cell transplantation from peripheral blood stem cells (PBSC) is being increasingly used in place of autologous bone marrow transplantation. PBSC following myeloblastic conditioning regimens reduced the period of marrow aplasia thus reducing morbidity, mortality and resource utilization. We report three cases of patients with acute leukaemia who received PBSC transplantation. Materials and Methods: Patient-1 is a 37-year old male with acute lymphoblastic leukaemia (ALL), patient-2, a 42-year old male and patient-3 a 57-year old female, both with acute myeloblastic leukaemia (AML) underwent 2-day fludarabine conditioning and peripheral blood stem cell infusion. The routine white blood cell count, haemoglobin and platelets were monitored periodically for four months. Absolute neutrophil count (ANC), haemoglobin and platelets were determined. Results: At 30 months from procedure the AML patients were reportedly still in good health and showed no evidence of relapse except for the ALL patient who had a relapse after 20 months and passed away one month later. Stem/Progenitor/blast cells showed an average loss of 33.5% after 2-day of storage at 4oC before the infusion. There was a sudden drop in ANC and platelets following post-infusion but returns to stable normal levels after 7- days. The haemoglobin levels showed irregular patterns but remains in normal stable state by four months. Discussion and Conclusion: The 2-day fludarabine conditioning in PBSC transplantation for acute leukaemia showed promise and sets new challenges for further study.