Unrelated cord blood transplantation in a child with very severe aplastic anemia

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  • YASUI Naoko
    Department of Hematology/Oncology, Saitama Children's Medical Center
  • KOH Katsuyoshi
    Department of Hematology/Oncology, Saitama Children's Medical Center
  • PARK Myoung-Ja
    Department of Hematology/Oncology, Gunma Children's Medical Center
  • KATO Motohiro
    Department of Hematology/Oncology, Saitama Children's Medical Center
  • MORI Makiko
    Department of Hematology/Oncology, Saitama Children's Medical Center
  • AKIYAMA Kosuke
    Department of Hematology/Oncology, Saitama Children's Medical Center
  • SEKI Masafumi
    Department of Hematology/Oncology, Saitama Children's Medical Center
  • TAKAHASHI Hiroyoshi
    Department of Hematology/Oncology, Saitama Children's Medical Center
  • HANADA Ryoji
    Department of Hematology/Oncology, Saitama Children's Medical Center

Bibliographic Information

Other Title
  • 非血縁者間臍帯血移植を施行した小児最重症再生不良性貧血
  • 症例報告 非血縁者間臍帯血移植を施行した小児最重症再生不良性貧血
  • ショウレイ ホウコク ヒケツエンシャ カン サイタイケツ イショク オ シコウ シタ ショウニ サイジュウショウ サイセイ フリョウセイ ヒンケツ

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Description

Recently, bone marrow transplantation from an unrelated donor has been recommended as an option for the treatment of very severe aplastic anemia (vSAA) refractory to immunosuppressive therapy (IST) in the absence of a human leukocyte antigen-matched related donor (MRD). For SAA patients with complications such as bacterial infections, prompt transplantation using either a mismatched related donor or cord blood (CB) becomes necessary. However, the former option is associated with graft-versus-host disease, whereas the latter option is associated with a more significant risk of graft failure. We report a patient with vSAA refractory to IST that was repeatedly complicated by bacterial infection. An MRD was unavailable for this patient, so we decided on emergent transplantation and successfully performed CB transplantation (CBT) using a low-dose TBI conditioning regimen. Although it may be necessary to examine more clinical cases in the future, a conditioning regimen such as that involving low-dose TBI may decrease the risk of graft failure, and CBT may become a treatment option for vSAA in the absence of a suitable donor.

Journal

  • Rinsho Ketsueki

    Rinsho Ketsueki 53 (12), 1997-2002, 2012

    The Japanese Society of Hematology

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