{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:12:44Z","timestamp":1760148764588,"version":"build-2065373602"},"reference-count":48,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2023,6,2]],"date-time":"2023-06-02T00:00:00Z","timestamp":1685664000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>In order to expand the donor pool and accessibility of the transplant procedure, it was necessary to introduce haplo-identical stem cell transplants in the Fundeni Clinical Institute from 2015. Even if the Romanian population is an ethnically compact white population, many of the patients referred for bone marrow transplant lack a suitable donor. Hematopoietic stem cell transplant from a haplo-identical donor is an alternative option for those patients without an HLA (Human Leucocyte Antigen)-matched donor (sibling or matched unrelated). This procedure was used also as a salvage option for those who experienced engraftment failure or the rejection of the first stem cell graft. In this case series, we present three such cases, with a haplo-transplant used as a salvage protocol (after an engraftment failure or rejection of the first transplanted cells). The patients we present were diagnosed with AML (acute myeloid leukemia) with MDS (myelodysplastic syndrome), MDS\u2014RAEB 2 (myelodysplastic syndrome\u2014refractory anemia with excess blasts 2), and SAA (severe aplastic anemia). In two of the three cases, the engraftment failure may have been due to the conditioning Fludarabine\/Busulfan\/Cyclophosphamide (Flu\/Bu\/CFA) used, combined with marrow grafts. In all three cases, the second transplant was of haplo-identical peripheral blood stem cells using Melphalan\/Fludarabine (Mel\/Flu) conditioning, the cells engrafted properly and the patients experienced complete chimerism, and two of them are alive with an excellent quality of life.<\/jats:p>","DOI":"10.3390\/medicina59061077","type":"journal-article","created":{"date-parts":[[2023,6,2]],"date-time":"2023-06-02T10:08:41Z","timestamp":1685700521000},"page":"1077","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Series Using Salvage Haplo-Identical Stem Cells for Secondary Transplantation"],"prefix":"10.3390","volume":"59","author":[{"given":"Alexandra","family":"Ionete","sequence":"first","affiliation":[{"name":"Fundeni Clinical Institute, 022328 Bucharest, Romania"},{"name":"Faculty of General Medicine, University of Medicine and Pharmacy \u201cCarol Davila\u201d, 020021 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zsofia","family":"Varady","sequence":"additional","affiliation":[{"name":"Fundeni Clinical Institute, 022328 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Orsolya","family":"Szegedi","sequence":"additional","affiliation":[{"name":"Faculty of General Medicine, University of Medicine and Pharmacy \u201cCarol Davila\u201d, 020021 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Coriu","sequence":"additional","affiliation":[{"name":"Fundeni Clinical Institute, 022328 Bucharest, Romania"},{"name":"Faculty of General Medicine, University of Medicine and Pharmacy \u201cCarol Davila\u201d, 020021 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,6,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"778","DOI":"10.1097\/00007890-199510270-00003","article-title":"Impact of racial genetic polymorphism on the probability of finding of HLA-matched donor","volume":"60","author":"Beatty","year":"1995","journal-title":"Transplantation"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1111\/j.1600-065X.1997.tb00979.x","article-title":"Hematopoietic stem cell transplants from unrelated donors","volume":"157","author":"Hanson","year":"1997","journal-title":"Immunol. 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