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Mucositis and pneumonitis: 13 case reports In a retrospective study involving 13 patients, who underwent unrelated donor haematopoietic stem cell transplantation for severe aplastic anaemia, 13 patients (9 male and 4 female patients) aged 3–52 years were described, who developed mucositis or pneumonitis following treatment with cyclophosphamide, fludarabine or antithymocyte globulin [routes, duration of treatments to reactions onsets and outcomes not stated; not all outcomes stated]. The patients, who had severe aplastic anaemia, were scheduled to undergo unrelated donor haematopoietic stem cell transplantation. Eleven of these patients had failed various past immunosuppressive therapies. The patients were cytomegalovirus IgG-positive. Prior to the transplantation, the patients received conditioning regimen with cyclophosphamide 50 mg/kg, fludarabine 150 mg/m2 and total body irradiation (6 patients), cyclophosphamide 29 mg/kg, fludarabine 150 mg/m2 and total body irradiation (4 patients), cyclophosphamide 29 mg/kg, fludarabine 160 mg/m2 and total body irradiation (1 patient), antithymocyte globulin 4.5 mg/kg, cyclophosphamide 29 mg/kg, fludarabine 150 mg/m2 and total body irradiation (1 patient), and antithymocyte globulin 4.5 mg/kg, cyclophosphamide 50 mg/kg, fludarabine 150 mg/m2 and total body irradiation (1 patient). The patients underwent transplantation between 2015–2019. The patients received graft-versus-host disease prophylaxis with post-transplantation cyclophosphamide 50 mg/kg on day +3 and +4 along with ciclosporin, tacrolimus or mycophenolate mofetil. However, all the patients developed conditioning regimen associated toxicity in the form of grade I–IV mucositis. At the time of last follow-up examination, 11 patients were alive; one patient died due to cytomegalovirus pneumonitis probably related to cytomegalovirus and respiratory syncytial virus infection, and cyclophosphamide therapy was considered as contributory in the development of pneumonitis. Another patient died due to secondary graft failure. Arcuri LJ, et al. A Case Series of Post-Transplantation Cyclophosphamide in Unrelated Donor Hematopoietic Cell Transplantation for Aplastic Anemia. Biology of Blood and 803519513 Marrow Transplantation 26: e222-e226, No. 9, Sep 2020. Available from: URL: http://doi.org/10.1016/j.bbmt.2020.05.023

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Reactions 5 Dec 2020 No. 1833