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A novel TBI free conditioning protocol for haploidentical transplant in acquired aplastic anemia: (FluCAB-Prime)

Bone Marrow Transplantation volume 56, pages 2309–2311 (2021)Cite this article

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Allogeneic hematopoietic stem cell transplant (HSCT) is the standard treatment for patients younger than 40 years with severe and very severe aplastic anemia (AA) who have a matched related donor (MRD) [1]. For patients lacking a MRD, treatment options include immunosuppressive therapy (IST), matched unrelated donor (MUD) or alternate donor (haploidentical/cord blood) transplant [2]. Pakistan has a population of around 230 million but there is no donor registry for MUD transplants and horse antithyomcyte globulin (hATG) is not available. Over past decade, results of haploidentical transplants have improved remarkably with the use of post-transplant cyclophosphamide (PTCy) and GCSF-ATG protocols enabling haplo-HSCT in large number of AA patients [3,4,5,6]. Most of the PTCy based protocols incorporate total body irradiation (TBI) to improve engraftment and reduce graft failure [7], however TBI is not available in most of the transplant centers across Pakistan. We have developed a novel TBI free conditioning regimen: FluCAB-prime (NCT03955601) for haploidentical HSCT in acquired AA patients lacking a MRD.

We conducted a prospective, single center, interventional trial (NCT03955601) using novel TBI free conditioning at Armed forces bone marrow transplant center (AFBMTC)/National institute of blood and marrow transplant (NIBMT) for patients with acquired severe and very severe AA (SAA/VSAA).

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Authors and Affiliations

  1. Department of Hematology and Stem Cell Transplant, Armed forces Bone Marrow Transplant Center/National Institute of Blood and Marrow Transplant, Rawalpindi, Pakistan

    Raheel Iftikhar, Qamarun Nisa Chaudhry, Syed Kamran Mahmood, Tariq Ghafoor, Nighat Shahbaz, Mehreen Ali Khan, Tariq Azam Khattak, Ghassan Umair Shamshad, Jahanzeb Rehman & Muhammad Farhan

  2. Shifa International Hospital, Islamabad, Pakistan

    Tariq Mehmood Satti

  3. Department of Hematology Oncology and Stem Cell Transplant, Quaid-e-Azam International Hospital, Islamabad, Pakistan

    Parvez Ahmed

Authors
  1. Raheel Iftikhar
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  2. Qamarun Nisa Chaudhry
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  3. Syed Kamran Mahmood
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  4. Tariq Ghafoor
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  5. Nighat Shahbaz
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  6. Mehreen Ali Khan
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  7. Tariq Azam Khattak
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  8. Ghassan Umair Shamshad
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  9. Jahanzeb Rehman
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  10. Muhammad Farhan
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  11. Tariq Mehmood Satti
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  12. Parvez Ahmed
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Contributions

RI, PA, and QN designed the study, analyzed the data and critically reviewed the manuscript. SKM, TG, NS, MAK, TAK, GUS, JR, MF, TS were involved in data collection and manuscript writing.

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Correspondence to Raheel Iftikhar.

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Iftikhar, R., Chaudhry, Q.N., Mahmood, S.K. et al. A novel TBI free conditioning protocol for haploidentical transplant in acquired aplastic anemia: (FluCAB-Prime). Bone Marrow Transplant 56, 2309–2311 (2021). https://doi.org/10.1038/s41409-021-01385-9

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  • DOI: https://doi.org/10.1038/s41409-021-01385-9

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