Second Stem Cell Transplantation in Patients with Fanconi Anemia Using Antithymocyte Globulin Alone for Conditioning

Despite the promising data on the outcome of allogeneic stem cell transplantation (SCT) in patients with Fanconi anemia (FA), a certain percentage of these patients still experience graft failure; some of these patients undergo second transplants, but the existing data on the outcome of the second SCT in FA patients are scarce, with no long-term follow-up provided in many of the publications addressing this issue. This is a review of our experience in 4 such patients who underwent second stem cell transplants using rabbit ATG only for conditioning. Three engrafted promptly and are alive and free of disease at 25, 23, and 21 months, respectively. We conclude, therefore, that the use of ATG alone for conditioning before a second SCT may offer a chance of long-term disease-free survival for FA patients who fail their first transplant.