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Cord Blood Stem Cells

Unrelated cord blood transplantation for newly diagnosed patients with severe acquired aplastic anemia using a reduced-intensity conditioning: high graft rejection, but good survival

Bone Marrow Transplantation volume 47, pages 1186–1190 (2012)Cite this article

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Abstract

We report a single-center experience in treating 18 consecutive patients with severe aplastic anemia (SAA) who received unrelated cord blood transplantation (CBT). The median age was 17 years (range 5–61 years). Sixteen cases received a reduced-intensity regimen composed of CY (total dose1200 mg/m2), rabbit antithymocyte globulin (ATG, total dose 30 mg/kg) and fludarabine (FLU, total dose 120 mg/m2). CYA and mycophenolate mofetil were used as GVHD prophylaxis. Two patients were not evaluable for engraftment because of early death on day +21 and +22. Only one of the sixteen cases achieved engraftment, but experienced secondary graft failure 3 months post transplantation. Fifteen patients experienced primary graft rejection, but all of them acquired autologous recovery. The 3-month and 6-month cumulative incidence of response was 56% and 81%, respectively. So far, 16 patients have survived for 330–1913 days (median, 750 days) after transplantation. The probability of OS at 2 years was 88.9%. Our data indicate that CBT for newly diagnosed SAA using no irradiation but FLU and ATG-based conditioning still seems to inevitably lead to the high risk of rejection, but may facilitate autologous recovery and improve survival with low risk of transplant-related mortality.

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Acknowledgements

This research was supported by the International Cooperation Research Fund of Anhui Provincial Scientific and Technologic Committee (08080703026), the Fund of the Key Medical Project of Anhui Provincial healthy department (2010A005) and Anhui Provincial ‘115’ Industrial Innovation Program (2009).

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  1. Department of Hematology, Anhui Provincial Hospital, Anhui Medical University, Hefei, China

    H-L Liu, Z-M Sun, L-Q Geng, X-B Wang, K-Y Ding, B-I Tang, J Tong & Z-Y Wang

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Correspondence to Z-M Sun.

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Liu, HL., Sun, ZM., Geng, LQ. et al. Unrelated cord blood transplantation for newly diagnosed patients with severe acquired aplastic anemia using a reduced-intensity conditioning: high graft rejection, but good survival. Bone Marrow Transplant 47, 1186–1190 (2012). https://doi.org/10.1038/bmt.2011.251

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