International Journal of Hematology

, Volume 83, Issue 2, pp 156–158 | Cite as

Successful Reduced-Intensity Hematopoietic Stem Cell Transplantation in Myelodysplastic Syndrome with Severe Coronary Artery Disease

  • Shigeki Kosugi
  • Makoto Hirokawa
  • Yoshinari Kawabata
  • Hitoshi Hasegawa
  • Tomoko Yoshioka
  • Ikuo Miura
  • Ken-ichi Sawada
Case Report


A 60-year-old Japanese man with myelodysplastic syndrome (MDS) and effort angina was referred to our clinic for treatment of MDS.The patient was transfusion-dependent and displayed coronary artery disease (CAD) with 99% obstruction of the left anterior descending coronary artery. Treatment comprised reduced-intensity hematopoietic stem cell transplantation with administration of fludarabine phosphate (180 mg/m2) and busulfan (8 mg/kg), followed by allogeneic peripheral blood stem cell transplantation from an HLA-matched sister. The regimen was well tolerated, and engraftment occurred rapidly without any therapy-related complications, including cardiovascular attack. Sex chromosome analysis by fluorescence in situ hybridization revealed complete donor chimerism on day 29 for bone marrow cells and on day 59 for peripheral blood leukocytes. The patient became transfusion-independent on posttransplantation day 8. As of 22 months postoperatively, he remains well, with 100% Karnofsky performance status, a limited type of chronic graft-versus-host disease, and no recurrence of disease. The clinical course of the patient suggests that this preparative regimen allows safe allogeneic stem cell transplantation for MDS patients with severe CAD.

Key words

Reduced-intensity hematopoietic stem cell transplantation Myelodysplastic syndrome Coronary artery disease 


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Copyright information

© The Japanese Society of Hematology 2006

Authors and Affiliations

  • Shigeki Kosugi
    • 1
  • Makoto Hirokawa
    • 1
  • Yoshinari Kawabata
    • 1
  • Hitoshi Hasegawa
    • 2
  • Tomoko Yoshioka
    • 1
  • Ikuo Miura
    • 1
  • Ken-ichi Sawada
    • 1
  1. 1.Divisions of aHematology and Oncology, Department of MedicineAkita University School of MedicineAkitaJapan
  2. 2.Cardiovascular Medicine, Department of MedicineAkita University School of MedicineAkitaJapan

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