Analsis Of Curative Effect For Allogeneic Hematopoietic Stem Cell Transplantation In The Treatment Of Nine Patients With Sever Aplastic Anemia

OBJECTIVE：To evaluate the curative effect and complications ofallogeneic hematopoietic stem cell transplantation(allo-HSCT) in thetreatment of severe aplastic anemia (SAA).METHODS: The clinical data from nine patients with severe acquiredaplastic anemia (SAA) from Nov2009to Feb2013in our hospital wereretrospectively analyzed. Among the nine patients, four patients receivedhaploidentical allo-HSCT, five patients received HLA-identical siblingtransplantation. Three patients were treated by allo-PBSCT and allo-BMTwith grafts from three one-haplotype mismatched donors, one patient wastreated by allo-PBSCT with grafts from a one-haplotype mismatched donor,five patients were treated by allo-PBSCT with grafts from HLA matchedrelated donors. All patients received a combination of fludarabine (FLU),cyclophosphamide (CY) and antithymocyte globulin (ATG) as conditioning. All recipients received cyclosporine (CsA), MycophenolateMofetil (MMF) and short-term methotrexate (MTX) for GVHDprophylaxis. The time of reconsitution of neutrophils (Neu) and platelets(Plt), the rate of engraftment, the incidence of infection withagranulocytosis, hepatic veno-occlusived disease (HVOD) and graft versushost disease (GVHD) were observed. Follow-up was performed to Mar2013after treatment to observe the patients’ survival.RESULTS: All the9patients achieved hematopoietic reconstitutionsuccessfully. Median time to neutrophils (neu) engraftment was11(range:10-16) days, Median time to platelets (Plt) engraftment was17(range:15-24) days. Nine patients were subjected to a bone marrowexamination at30th day. The Short Tandem Repeats (STR) detection ofpatient in bone marrow showed that engraftment was complete donors genetype. Median follow-up time was27.6(range:1-35) months. Skin aGVHDgrade III was observed in one patient with HLA-identical siblingtransplantation, the others didn’t experienced GVHD and othercomplications. Infections occurred in two cases with haploidenticalhematopoietic stem cell transplantation (HHCT), One patient wasdiagnosed with diffuse large B cell lymphoma (DLBCL) more than twomonths later, who received allo-HSCT from an HLA-identical siblingdonor, the other six patients live heath up to now.CONCLUSION: Allo-HSCT is an effectively treatment for SAA. Matched related donor allo-HSCT is the best treatment of choice forpatients with severe aplastic anemia (SAA). Haploidentical HSCT could beconsidered for patients with SAA.