Invasive Pulmonary Aspergillosis Is Not a Contraindication to Reduced-Intensity Conditioned Allogeneic Haematopoietic Stem Cell Transplantation (RIC allo-HSCT).

Aloysius Y.L. Ho, Sujal R. Desai, Ian D.P. Stanton, Susan J. Copley, Athol U. Wells, Antonio Pagliuca, Stephen Devereux, and Ghulam J. Mufti

Author address: 

1 Department of Haematological Medicine, King’s College Hospital, London, United Kingdom; 2 Department of Radiology, King’s College Hospital, London, United Kingdom; 3 Department of Radiology, Hammersmith Hospital, London, United Kingdom and 4 Inters

Abstract: 

Ten patients with focal abnormalities on CT prior to RIC allo-ASCT, in whom follow-up CT studies were available, were studied. All 10 had received prior chemotherapy for AML/MDS and had received treatment for high probability invasive pulmonary aspergillosis (IPA). The RIC protocol comprised FBC- fludarabine 30 mg/m2 intravenously from Day -9 to Day -5; busulphan 4mg/kg/day orally from Day -3 to Day -2 and alemtuzumab (CAMPATH-1H) 20mg intravenously from Day -8 to Day -4. Unselected peripheral blood stem cells (PBSCs) or bone marrow (BM) was infused on Day 0. Immunosuppression was achieved with cyclosporine 1.5 mg/kg intravenously 12 hourly from Day -1. Neoralí¢ was substituted when a good oral intake was tolerated and tapered from Day +56 in the absence of GvHD. Filgrastim 300 mcg iv/sc was administered from Day +7 to neutrophil engraftment (neutrophils 0.5x109/l). All patients received standard nursing and supportive care protocols for neutropenic patients. In addition these patients received Ambisome 3mg/kg intravenously daily until full neutrophil regeneration had occurred, then prophylactic Ambisome (2mg/kg thrice a week) till immunosuppression was stopped. Two thoracic radiologists (blinded to the timing of examinations) independently reviewed the CT studies pre- and post-RIC allo-HSCT. The site and size of individual lesions was evaluated. The likelihood (recorded as probable, possible, indeterminate or unlikely; denoting probabilites of 75%, 50%, 25% and
2007

abstract No: 

1831

Full conference title: 

49th American Society of Haematologists Annual Meeting
    • ASH 49th (2007)