We retrospectively analyzed the clinical features, transplantation results and survival of patients with severe aplastic anemia (SAA) treated with allogeneic stem cell transplantations (ASCT) in adult transplantation unit.
Materials and Methods: Eleven patients (6 male, 5 female) treated with 12 ASCTs were analyzed. All patients except 2 were treated with immunosuppressive treatment before ASCT. Peripheral CD34+ stem cells from HLA matched sibling donors (MSD) were transfused after conditioning regimens including cyclophosphamide, busulphan, antithymocyte globulin and fludarabine.
Results: The median age at ASCT and time from diagnosis to ASCT were 22 years (17-38) and 9 months (3-108), respectively. The median 5.49 x 106/kg (4.9-12.7 x 106/kg) CD34+cells were transfused. The median duration of time to neutrophil and platelet engraftments were 21.5 (10-37) and 15 (14-29) days, respectively. Acute graft versus host disease (GVHD) and limited chronic GVHD were observed in 4 (36.3%) patients and 1 (9%) patient, respectively. Graft failure was seen in 2 (18.1%) of 11 patients. The median follow-up period was 33.5 months (0.5-59). Four (36.3%) of 11 patients died due to infection (3 patients) and liver failure (1 patient). Approximately 64% of all recipients are alive. The 5-year overall and event-free survival rates were 66.7% and 58.3%, respectively.
Conclusion: Although we have few patients, our findings are seems to support that ASCT from a MSD remains the first choice for SAA patients younger than 40 years. Presence of MSD, shorter time from diagnosis to ASCT, using optimal conditioning regimens and choosing optimal stem cell source are seems to increase the success and survival rates of transplantation.