The treatment of nonmyeloablative unrelated peripheral blood stem cell transplantation for severe aplastic anemia

Objective To explore the treatment and effect of unrelated hematopoietic cell transplantation for severe aplastic anemia(SAA).Methods 1 patient with SAA received nonmyeloablative conditioning regimens of cyclophosphamide(100mg/kg)+fludarabine(150mg/m2)+antithymocyte globulin(ATG)(100mg/kg),G-CSF mobilization,peripheral blood stem cell at 2 locus mismatched transplantation.MNC 6.77×108/kg and CD+34 cell 1.95×106/kg were infused.Graft versus host disease(GVHD)prophylaxis consisted of cyclosporin-A(CsA),methotrerate(MTX)and mycophenolate mofetil(MMF).Results The hematopoietic stem cell was transplanted successfully.The WBC and PLT were graftted respectively in +6d and +8d.The DNA fingerprinting showed engraftement by short tadom repeated-PCR(STR-PCR)in +30d.The blood type was changed into the type of donor(O→A)in +150d.None of the acute GVHD(aGVHD)and chronic GVHD(cGVHD)were observed.The patient was followed for 8 months after allo-HSCT,and the function of hemopoiesis was well.Conclusions The treatment of unrelated HSCT with fudarabine,cyclophosphamide and ATG nonmyeloablative conditioning allowed for good engraftment without serious complications for SAA without HLA-identical sibling.