SUCCESSFUL 2ND BONE-MARROW TRANSPLANT FOR FANCONIS-ANEMIA FOLLOWING ESCALATION OF CONDITIONING

Allogeneic bone marrow transplantation represents the treatment of cho ice for severe bone marrow failure in patients with Fanconi's anaemia (FA). In view of the increased sensitivity to alkylating agents docume nted in this condition, much attention has focused on reducing the con ditioning chemotherapy. We present a 13-year-old girl in whom sibling allogeneic BMT after conditioning with low-dose cyclophosphamide only resulted in graft rejection. However, a second transplant using the sa me donor proved successful following a more intensive conditioning reg imen. This case demonstrates the phenotypic variability of FA, and hig hlights the need for tailoring the conditioning regimen for a given pa tient.