Hematopoietic stem cell transplantation for aplastic anemia and paroxysmal nocturnal hemoglobinuria: current evidence and recommendations

Expert Rev Hematol. 2014 Dec;7(6):775-89. doi: 10.1586/17474086.2014.967678. Epub 2014 Oct 21.

Abstract

Aplastic anemia (AA) is a bone marrow failure syndrome characterized by pancytopenia and an empty bone marrow. Standard treatments for AA include immunosuppressive therapy and bone marrow transplantation (BMT). BMT is the preferred option for young AA patients with a sibling donor, whereas in older patients or in those to be grafted from an unrelated donor BMT is exploited as second-line treatment. Current results of BMT for AA demonstrate cure rates up to 80 and 70% in BMT from HLA-matched siblings and unrelated donor, respectively, with age and stem cell source largely affecting the outcome. BMT is also a potential treatment option for paroxysmal nocturnal hemoglobinuria, a rare hematological disorder characterized by complement-mediated intravascular hemolytic anemia, thrombophilia and bone marrow failure.

Keywords: aplastic anemia; bone marrow failure; bone marrow transplantation; immunosuppressive treatment; paroxysmal nocturnal hemoglobinuria.

Publication types

  • Review

MeSH terms

  • Anemia, Aplastic / therapy*
  • Animals
  • Bone Marrow Transplantation / methods
  • Hematopoietic Stem Cell Transplantation / methods*
  • Hemoglobinuria, Paroxysmal / therapy*
  • Humans
  • Immunosuppressive Agents / therapeutic use

Substances

  • Immunosuppressive Agents