¹Bone Marrow Transplant Unit, Hematology Service, University Hospital La Fe, Valencia, Spain

Correspondence: Dr MA Sanz, Section of Clinical Hematology, Hospital Universitario La Fe, Avda Campanar, 21, Valencia, Spain. E-mail: msanz@uv.es

Received 25 October 2004; Accepted 25 April 2005; Published online 20 June 2005.

Abstract

We evaluated the use of CD34+ selected allogeneic peripheral blood as a source of hematopoietic progenitors for allogeneic transplantation in 11 patients with aplastic anemia (AA). The median age was 17 years (range, 6–49), and the median time between diagnosis and transplant 1 month (range, 1–24). Conditioning consisted of cyclophosphamide (50 mg/kg per day) on days -7 to -4 and antithymocyte globulin (30 mg/kg per day) on days -4 to -2 in nine patients. Total lymphoid irradiation was added to the preparative regimen for two. Graft-versus-host disease (GVHD) prophylaxis consisted of cyclosporine A and prednisone. Median doses of CD34+ and CD3+ cells infused were 3.91 10⁶ and 0.3 10⁶/kg, respectively. The median time taken to achieve a neutrophil count >0.5 10⁹/l was 12 days and to recover a platelet count >20 10⁹/l, 13 days. Two patients developed acute GVHD grade I–II and one developed limited chronic GVHD. There were two treatment-related deaths. At a median follow-up of 44 months (range, 4–73), nine patients were alive with sustained and complete engraftment. This is a promising procedure in patients with AA, resulting in a rapid hematopoietic recovery, a low transplant-related mortality, and a low incidence of GVHD.