Successful engraftment of a second transplant using non-myeloablative conditioning as treatment for graft failure following unrelated donor BMT.

A 32-year-old man with CML in second chronic phase developed primary graft failure following matched unrelated donor transplantation using cryopreserved marrow cells. He was successfully regrafted within 60 days from a second fully matched donor using a non-myeloablative conditioning regimen, with minimal toxicity. He remains in complete haematological, cytogenetic and molecular remission 2 years after second transplant. We believe that reduced intensity or 'mini-transplants' may be preferable for patients requiring second allografts which are usually associated with a high transplant-related mortality.