Title:Allogeneic Hematopoietic Stem Cell Transplant for Severe Aplastic Anemia: Current State and Future Directions
Volume: 13
Issue: 5
Author(s): Qixin Sun, Bingyi Wu*, Zhigang Zhu, Can Sun, Jingxia Xu, Hui Long, Yuxian Huang, Jianhui Xu and Chaoyang Song
Affiliation:
- Department of Hematology, Zhujiang Hospital, Southern Medical University, Guangzhou,China
Keywords:
Severe aplastic anemia, allogeneic, transplantation, hematopoietic stem cell, bone marrow, hematology.
Abstract: Acquired severe aplastic anemia (SAA) is a rare and life-threatening bone marrow failure
syndrome characterized by cytotoxic T-cells excessive activity, hematopoietic precursors decrease and
peripheral blood (PB) pancytopenia. Patients with severe aplastic anemia (SAA) die 1 to 2 years after
diagnosis due to fatal infections and/or hemorrhagic complications if they do not undergo any effective
treatment. Nowadays, Immunosuppressive therapy (IST) and allogeneic hematopoietic stem cell transplantation
(HSCT) are still the standard treatment for SAA. For patients younger than 40 years old,
allogeneic HSCT is often the best choice. Recently, outcomes of matched unrelated donor and haploidentical
donor transplantation have significantly improved, notably in some cases which are comparable
to the result of matched related donor transplantation. Mixed chimerism status is more common in
SAA post-transplantation patients, which is effected by conditioning regimen used in transplantation
and is closely relevant to donor cells rejection and secondary graft failure. In this article, we briefly
have reviewed the current state and future directions for SAA HSCT, and have shared our SAA data
and transplant experience of the recent decade. We have analyzed the impact of conditioning regimen
on engraftment and chimerism status in SAA transplantation, and have compiled our findings in this
report.
