Clinical analysis of six children with aplastic anemia after allogeneic hematopoietic stem cell transplanta-tion

Abstract

Objective To explore the efficacy of allogeneic hematopeietic stem cell transplantation in children with aplastic anemia. Methods In six children with aplastic anemia, five children received G-CSF primed allogeneic bone marrow plus peripheral stem cell transplantation from HLA-matched siblings, the nucleat- ed cell dose of BM and PBSC transplanted was respectively 4. 61 ( 1.5 ～ 13.2)×108/kg and 9. 36(2. 05 ～ 16. 75 )×108/kg. All five cases used FLU + CTX + ATG as the conditioning regimens. One child received unre-lated HLA-matched bone marrow transplantation, the nucleated cell dose of BM transplanted was 16. 8 x 10S/kg, and used FLU + CTX + TBI as the conditioning regimen. All cases received CSA + MTX + MMF as acute GVHD prophylaxis. Results One child got graft failure and the hematopoiesis recovered at 23 days by itself. The other five children achieved hematopoietic recovery after transplantation. None of them got GVHD after transplanta-tion. One child who had got MAA for four years happened graft rejection,got disease recurrence and finally died of serious infection. Other five children got disease-free survival with a follow-up to Feb 2009. Conclusion AI-logeneic bone marrow plus peripherial stem cell transplantation from HLA-matched siblings could be considered as the preferred treatment for children with aplastic anemia. It is feasible for children with aplastic anemia to re-ceive bone marrow transplant from unrelated HLA-matched donors when the patient was failed in immunosup-pressive therapy and without an available sibling donor. Key words: Hematopeietic stem cell transplantation; Aplastic anemia; Children