Abstract

Objective To compare and evaluate the clinical effectiveness of non-myeloablative stem cell transplantation from related donor vs unrelated umbilical cord blood(UCB)for patients with severe aplastic anemia(SAA). Methods The clinical data of 15 patients with SAA were retrospectively analyzed. According to the sources of hematopoietic stem cells,patients were divided into bone marrow transplantation(BMT)group(n=6) and UCB transplantation(UCBT) group(n=9)and both of them subjected to nonmyeloablative stem cell transplantation. Long-term follow-up results including peripheral blood,bone marrow,chimerism status,graft-versus-host disease(GVHD),and survival rate were analyzed statistically. Results There was different engraftment rate between BMT group(100%)and UCBT group(66.7%)(P＜0.05). Most patients achieved mixed chimerism(MC)in UCBT group and full donor chimerism in BMT group. Patients achieved normal level of peripheral blood cell at median time of 120 days in UCBT group and 25 days in BMT group, and achieved normal haematopoietic level in bone marrow at median time of 40 days in BMT group and 150 days in UCBT group posttransplantation,respectively. Chronic GVHD mostly presented abnormal liver function and local skin rash in BMT and in UCBT groups respectively. There was different infectious incidence at early phase between UCBT group(33.3%) and BMT group(16.7%) (P＜0.05). Blood group in UCBT group had delayed and less change as compared with BMT group Conclusions Nonmyeloablative stem cell transplantation from related bone marrow and unrelated cord blood can achieved successful engraftment. In comparison to BMT group, patients in UCBT group were mostly characterized with slower hematopoietic recovery,less and delayed change of blood group,higher incidence of infection at early phase posttranplant,and milder chronic GVHD. Key words: Hematopoietic stem cell transplantation; Anemia,aplastic; Bone marrow; Peripheral blood:Cord blood

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