Allogeneic hematopoietic stem cell transplantation for severe aplastic anemia

doi:10.3969/j.issn.2095-4344.2015.06.015

Abstract

Abstract:

BACKGROUND: In recent years, with the development of hematopoietic stem cell transplantation technique and the use of immunosuppressants, the therapeutic effects on severe aplastic anemia have been improved significantly. Especially relative HLA-identical matching allogeneic hematopoietic stem cell transplantation has achieved a high cure rate.
OBJECTIVE: To explore the feasibility of allogeneic hematopoietic stem cell transplantation for the treatment of severe aplastic anemia.
METHODS: From 2009 to 2011, 20 patients with severe aplastic anemia received fludarabine, cyclophosphamide and antithymocyte globilin as preconditioning before allogeneic hematopoietic stem cell transplantation from 12 matched and 8 mismatched donors. Except one case undergoing unrelated peripheral blood stem cell transplantation, grafts were from mobilized peripheral blood and bone marrow in all cases. Graft versus host disease prophylaxis consisted of cyclosporine-A and short-course methotrexate in the HLA-identical patients as well as cyclosporine, methotrexate, and short-course mycophenolate mofetil in HLA-mismatched patients.
RESULTS AND CONCLUSION: After transplantation, the time to recover the neutrophil count above > 0.5×109/L was median 12.5 days, and the time to recover the platelet count above > 20×109/L was median 18 days. Twenty patients were followed up for 24-60 months. The overall survival rate was 75% (n=15), the event-free survival rate was 70% (n=14). Five cases died. The event-free survival rate were 83% (10/12 patients) for HLA-identical patients and 50% (4/8 patients) for HLA-mismatched patients. Acute and chronic graft versus host disease was
found in 5 of 20 patients, severe bacterial infection in 4 of 20 patients and fungal infections in 3 of 20 patients. Allogeneic stem cell transplantation is effective in the treatment of severe aplastic anemia, especially for HLA-identical patients.

中国组织工程研究杂志出版内容重点：干细胞；骨髓干细胞；造血干细胞；脂肪干细胞；肿瘤干细胞；胚胎干细胞；脐带脐血干细胞；干细胞诱导；干细胞分化；组织工程

全文链接：

Key words: Anemia, Aplastic, Hematopoietic Stem Cell Transplantation, Graft vs Host Disease

CLC Number:

R394.2

Xi Rui, Bai Hai, Wang Cun-bang. Allogeneic hematopoietic stem cell transplantation for severe aplastic anemia[J]. Chinese Journal of Tissue Engineering Research, 2015, 19(6): 912-.

Figures/Tables 1

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