High-dose peripheral blood stem cell transplant for multitransfused severe aplastic anaemia patients without antithymocyte globulin in the conditioning regimen

Bone Marrow Transplant. 1999 Oct;24(8):845-8. doi: 10.1038/sj.bmt.1701986.

Abstract

Four multitransfused patients with severe aplastic anaemia (SAA) are described. Two received a BMT after conditioning with cyclophosphamide (Cy) plus antithymocyte globulin (ATG). Both suffered a graft failure (GF) and had a second transplant with PBSC from the original donor. Two other patients received a PBSCT as a first option, with Cy as the only conditioning drug. The four patients received methotrexate (MTX) and cyclosporine (CYA) as post-grafting immunosuppression. The two BMT patients with GF were successfully rescued with a PBSC second transplant. In the two cases where a PBSCT was done as a first option no GF was observed and a successful and complete haematological recovery was achieved. In conclusion, PBSCT rescued two SAA patients with GF after BMT. PBSCT without ATG as a first option produced a quick and complete haematological recovery in two additional patients, suggesting that PBSCT without ATG can be an alternative to BMT plus ATG in SAA as a first transplant option.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Anemia, Aplastic / therapy*
  • Antilymphocyte Serum / administration & dosage
  • Blood Transfusion*
  • Cyclophosphamide / administration & dosage
  • Cyclosporine / administration & dosage
  • Female
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Immunosuppressive Agents / administration & dosage
  • Male
  • Methotrexate / administration & dosage

Substances

  • Antilymphocyte Serum
  • Immunosuppressive Agents
  • Cyclosporine
  • Cyclophosphamide
  • Methotrexate