Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Letter to the Editor
  • Published:

Haploidentical hematopoietic stem cell transplantation for nonresponders to immunosuppressive therapy against acquired severe aplastic anemia

Bone Marrow Transplantation volume 51, pages 424–427 (2016)Cite this article

Subjects

Severe aplastic anemia (SAA) patients unresponsive to initial immunosuppressive therapy or those who experience clonal evolution will be considered for transplantation using an alternative donor.1 Alternative donors, including haploidentical family donors have been reported.2 Transplants with haploidentical donors are considered to be at high risk of adverse outcome.3 When the partially matched family donor transplant option was initially used, it was unsuccessful owing to the high rate of graft failure (GF) and refractory GvHD, despite its ability to render donors available to almost all patients.2, 4 Delayed immune recovery and the high incidence of infection were also major clinical obstacles.5, 6 These drawbacks affect the universal use of haploidentical hematopoietic stem cell transplantation (Haplo-HSCT) for SAA. Although haplo-HSCT has been greatly improved during the past decade, they are usually regarded as a third-line treatment for SAA.7

We retrospectively summarized 26 patients who failed to respond to previous therapy and underwent haplo-HSCT. The current report discusses the outcomes of haplo-HSCT treatment options in patients with SAA for whom no HLA-identical donor was available at the First Affiliated Hospital of Soochow University and the Second People’s Hospital of Huai’an from 2005 to 2013.

This is a preview of subscription content, access via your institution

Relevant articles

Open Access articles citing this article.

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1

References

  1. Socie G . Allogeneic BM transplantation for the treatment of aplastic anemia: current results and expanding donor possibilities. Hematology 2013; 2013: 87–94.

    Article  Google Scholar 

  2. Xu LP, Liu KY, Liu DH, Han W, Chen H, Chen YH et al. A novel protocol for haploidentical hematopoietic SCT without in vitro T-cell depletion in the treatment of severe acquired aplastic anemia. Bone Marrow Transplant 2012; 47: 1507–1512.

    Article  CAS  PubMed  Google Scholar 

  3. Scheinberg P . Aplastic anemia: therapeutic updates in immunosuppression and transplantation. Hematology 2012; 2012: 292–300.

    PubMed  Google Scholar 

  4. Im HJ, Koh KN, Choi ES, Jang S, Kwon SW, Park CJ et al. Excellent outcome of haploidentical hematopoietic stem cell transplantation in children and adolescents with acquired severe aplastic anemia. Biol Blood Marrow Transplant 2013; 19: 754–759.

    Article  PubMed  Google Scholar 

  5. Keever CA, Small TN, Flomenberg N, Heller G, Pekle K, Black P et al. Immune reconstitution following bone marrow transplantation: comparison of recipients of T-cell depleted marrow with recipients of conventional marrow grafts. Blood 1989; 73: 1340–1350.

    CAS  PubMed  Google Scholar 

  6. Handgretinger R, Klingebiel T, Lang P, Gordon P, Niethammer D . Megadose transplantation of highly purified haploidentical stem cells: current results and future prospects. Pediatr Transplant 2003; 7: 51–55.

    Article  PubMed  Google Scholar 

  7. Lu DP, Dong L, Wu T, Huang XJ, Zhang MJ, Han W et al. Conditioning including antithymocyte globulin followed by unmanipulated HLA-mismatched/haploidentical blood and marrow transplantation can achieve comparable outcomes with HLA-identical sibling transplantation. Blood 2006; 107: 3065–3073.

    Article  CAS  PubMed  Google Scholar 

  8. Marsh JC, Ball SE, Cavenagh J, Darbyshire P, Dokal I, Gordon-Smith EC et al. Guidelines for the diagnosis and management of aplastic anaemia. Br J Haematol 2009; 147: 43–70.

    Article  CAS  PubMed  Google Scholar 

  9. Tzeng CH, Chen PM, Fan S, Liu JH, Chiou TJ, Hsieh RK . CY/TBI-800 as a pretransplant regimen for allogeneic bone marrow transplantation for severe aplastic anemia using HLA-haploidentical family donors. Bone Marrow Transplant 1996; 18: 273–277.

    CAS  PubMed  Google Scholar 

  10. Gupta V, Eapen M, Brazauskas R, Carreras J, Aljurf M, Gale RP et al. Impact of age on outcomes after bone marrow transplantation for acquired aplastic anemia using HLA-matched sibling donors. Haematologica 2010; 95: 2119–2125.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Peinemann F, Grouven U, Kroger N, Bartel C, Pittler MH, Lange S . First-line matched related donor hematopoietic stem cell transplantation compared to immunosuppressive therapy in acquired severe aplastic anemia. PLoS ONE 2011; 6: e18572.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Scheinberg P, Young NS . How I treat acquired aplastic anemia. Blood 2012; 120: 1185–1196.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

This work was supported by the Network Hospital of Clinical Medicine Science and Technology Project, Jiangsu Science and Technology Department (No. BL2012005), Hematology Academician Workstation of Huai’an City (No. HAP201321), the Priority Academic Program Development of Jiangsu Higher Education Institutions (PAPD), Jiangsu Province’s Key Medical Center (ZX201102), National Clinical Key Specialty Development Project and National Public Health Grand Research Foundation (No. 201202017).

Author information

Author notes

  1. L Liu, X Wang, S Jin and L Hao: These authors contributed equally to this work.

Authors and Affiliations

  1. Department of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Collaborative Innovation Center of Hematology, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China

    L Liu, X Wang, S Jin & D Wu

  2. Department of Hematology, The Second People’s Hospital of Huai’an, Huai’an, China

    L Liu, Y Zhang & X Zhang

  3. Department of Hematology, The People’s Hospital of Peixian, Peixian, China

    L Hao

Authors
  1. L Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. X Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. S Jin
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. L Hao
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Y Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. X Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. D Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to D Wu.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Liu, L., Wang, X., Jin, S. et al. Haploidentical hematopoietic stem cell transplantation for nonresponders to immunosuppressive therapy against acquired severe aplastic anemia. Bone Marrow Transplant 51, 424–427 (2016). https://doi.org/10.1038/bmt.2015.249

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/bmt.2015.249

This article is cited by

Search

Advanced search

Quick links