In all cases it is strongly recommended to obtain optimal control of hemophagocytic syndrome previous to undertaking hematopoietic stem cell transplant. |
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A - Genotypical identical donor |
• Rabbit ATG day-14 to -10 (5 days), dose 10 mg/kg/day |
• Busulfan: day -10 to -7; age < 6y 5 mg/kg/day × 4;age > 6y 4 mg/kg/day × 4 |
• Cyclophosphamide: day -5 to -2; 50 mg/kg/day × 4 |
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B - Matched unrelated donor/Phenotype identical related donor/HLA-nonidentical haplo or mismatched family donor. |
• Rabbit ATG day-14 to -10 (5 days), dose 10 mg/kg |
• Busulfan: day -10 to -7; age < 6y 5 mg/kg/day × 4;age > 6y 4 mg/kg/day × 4 |
• Cyclophosphamide: day -5 to -2; 50 mg/kg/day × 4 |
• Positive selection of CD34+ cells in Stem cell source aiming to have T cell counts <104/kg |
• Ciclosporine A if T cell counts above 104/kg despite positive selection of CD34+ cells |