Characteristics and Outcomes of Severe Aplastic Anemia Patients Who Were Treated with Allogenic Hematopoietic Stemcell Transplantation at Institute Pediatric Hospital Kuala Lumpur during 2003-2012

Abstract

Aplastic anemia is characterized by the development of peripheral blood pancytopenia associated with hypocellularity of the bone marrow. Treatment strategies for aplastic anemia include immunosupressive therapy and hematopoietic stemcell transplantation. The choice of therapy depends on the severity of the disease, patient’s age and availability of a human leukocyte antigen (HLA) matched sibling donor. To describe the clinical characteristics and outcomes of all patients diagnosed with severe aplastic anemia who were treated with allogenic hematopoietic stemcell transplantation at IPHKL. All patients with SAA who had underwent matched sibling hematopoietic stemcell transplantation at IPHKL from January 2002- December 2013 were identified. Retrospective data was collected with regards to patient’s characteristics, transfusion history, conditioning regime, time of engraftment, length of stay, complication and outcomes of patients. In this study there were 36 patients with SAA who underwent allogenic hematopoietic stemcell transplantation. Of the 36 patients, 20 (55.6%) were boys and 16 (44.4%) were girls. The most regimes used for conditioning was combination of fludarabine, cyclophosphamide and ATG horse in 19 patients (52.8%). Mostly the granulocyte engraftment at 10 days after transplantation, while platelet engraftment occurred at 12 days after transplantation. Complications that occurred after transplant were febrile neutropenia in 32 patients (88.9%), mucositis in 25 patients (69.4%), fungal infection in 4 patients (11.1%) and only 2 patients had GvHD. No patients died after underwent allogenic hematopoietic stemcell transplantation. Thirty four patients (94.4%) were cured after a single hematopoietic stemcell transplantation, and only 2 patients (5.6%) had late graft rejection, but all were cured after having the second transplantation The outcomes of patients with severe aplastic anemia who had underwent allogenic hematopoietic stemcell transplantation in bone marrow transplantation ward IPHKL were good. All patients were cured from the disease.