Objective: To evaluate the efficacy of alternative donor allogeneic hematopoietic stem cell transplantation (AD allo-HSCT) in the treatment of severe aplastic anemia (SAA).
Methods: Retrospective analysis of the clinical data of 19 SAA patients received AD allo-HSCT from May 2003 to December 2012. Of them, 12 received haploidentical HSCT (haplo-HSCT), 7 received unrelated donor transplantation. The conditioning regimen was CY+ATG+Flu±Ara-C±Bu/Mel, the GVHD preventing regimen was MMF+MTX+CSA/FK506; the median reinfusion quantity of CD34+ was 3.10(2.11-4.38)×10⁶/kg in allo-BMT and 4.90(2.08-6.88)×10⁶/kg in allo-PBSCT.
Results: Hematopoiesis reconstitution was achieved in all 19 patients. Twelve patients developed acute graft-versus-host disease (aGVHD), and 7 developed chronic GVHD (cGVHD). Graft rejection (GR) was occurred in one patient. The median follow-up time was 13(3-115) months. Thirteen patients survived, and the prospective 5-year overall survival rate is (67.5±11.0)%.
Conclusion: AD allo-HSCT can be used as an alternative therapy for SAA patients without HLA matched sibling donor.