Efficacy of Allogeneic Hematopoietic Stem Cell Transplantation in Treatment of Severe Aplastic Anemia

Objective To explore the effectiveness of Allogeneic hematopoietic stem cell transplantation(allo-HSCT) in treating severe aplastic anemia(SAA).Methods Among the 8 patients,1 patient received allogeneic peripheral stem cell transplantation from an HLA matched sibling,4 patients received allogeneic bone marrow and peripheral stem cell transplantation from haploidentical donors(parents),3 patients received unrelated allogeneic peripheral stem cell transplantation.Conditioning regimens included:fludarabine,Cyeclophosphamide,anti-themocyte globulin(for unrelated and HLA matched sibling donors);fludarabine,Cyeclophosphamide,busulphan and anti-lymphocyte globulin(ALG)/anti-themocyte globulin(ATG)(for haploidentical donors).For prevention of graft versus host disease(GVHD) the patient with HLA matched sibling donor was administered with a combination of immunosuppressive drugs including CSA,short-course MTX while for the patients with haploidentical or unrelated donors,MMF,anti-CD25 monoclonal antibody and ATG were.also employed.Results All the 8 patients achieved hematopoietic reconstitution after transplantation.It took 10～17 days(:median:12.5 days) for the level of neutrophils to reach 0.5×109/L and 9-25 days(median:13.8 days) for platelets to reach 20×109/L.All the 8 patients became donor chimerism.As for the complications,CMV-related sepsis was found in 5 cases,hemorrhagic cystitis in 3 cases,GradeⅠ～Ⅲ graf-versus-host disease(GVHD) and chronic local GVHD in 2 patients,and central nervous system infection accompanied with pure red aplastic anemia in 1 case.All the patients survived during the follow-up(range:9～38 months;median:20 months).Conclusion Allo-HSCT is an effective approach for treating patients with SAA.It may be helpful to prolong the survivals of these patients.