International Journal of Hematology

DOI: 10.1007/s12185-017-2187-3 Pages: 686-691

HLA haploidentical hematopoietic cell transplantation using clofarabine and busulfan for refractory pediatric hematological malignancy

1. Tokyo Medical and Dental University (TMDU), Department of Pediatrics and Developmental Biology

2. Tokyo Medical and Dental University (TMDU), Department of Hospital Pharmacy

3. National Cancer Research Center, Department of Pediatric Oncology

4. Tokyo Medical and Dental University (TMDU), Department of Transfusion Medicine

5. Juntendo University, School of Medicine, Department of Pediatrics and Adolescent Medicine

6. Tokyo Medical and Dental University (TMDU), Department of Pharmacokinetics and Pharmacodynamics

7. National Center for Child Health and Development, Division of Leukemia and Lymphoma, Children’s Cancer Center

Correspondence to:
Masatoshi Takagi
Tel: +81-3-5803-5249
Email: m.takagi.ped@tmd.ac.jp

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Abstract

Haploidentical hematopoietic cell transplantation (HCT) conditioning with clofarabine and target area under the blood concentration–time curve (AUC)-based busulfan adjustment was performed in three patients with refractory pediatric leukemia. The target AUC for two patients who had already received multiple transplantations was 3600 and 4000 μmol min/L, and that for the patient with Down’s syndrome was 3000 μmol min/L. Regimen-related toxicity was well tolerated in all cases. All three maintained cytological remission throughout the follow-up period (between 31 and 167 weeks). Thus, haploidentical HCT conditioning with clofarabine and target AUC-based busulfan adjustment may be a preferable option for children with recurrent or refractory pediatric leukemia.

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