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Unrelated donor cord blood transplantation for childhood severe aplastic anemia after a modified conditioning
Author(s) -
Ohga Shouichi,
Ichino Kiyomi,
Goto Kazuna,
Hattori Sagano,
Nomura Akihiko,
Takada Hidetoshi,
Nakamura Katsumasa,
Hara Toshiro
Publication year - 2006
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/j.1399-3046.2006.00486.x
Subject(s) - medicine , aplastic anemia , transplantation , total body irradiation , cord blood , umbilical cord , surgery , hematopoietic stem cell transplantation , gastroenterology , regimen , complication , bone marrow , immunology , cyclophosphamide , chemotherapy
Treatment of severe aplastic anemia (SAA) patients who lack human leukocyte antigen (HLA)‐matched donors and failed immunosuppressive therapy (IST) is challenging. Recently, umbilical cord blood transplantation (CBT) after non‐myeloablative therapy has been reported in adult but not in childhood SAA. However, most cases resulted in mixed donor chimerism and incomplete hematological recovery. We reported an 11‐yr‐old girl with recurred SAA 5 yr after IST who underwent unrelated donor CBT after a modified regimen. This patient had renal and cardiac dysfunction, and lacked suitable bone marrow donors. The 3.9 × 10 7 /kg CB cells from an HLA one‐locus mismatched unrelated donor were infused after conditioning with total body irradiation (5 Gy), melphalan (120 mg/m 2 ), and fludarabin (120 mg/m 2 ). Hematological recovery was favorable in complete chimerism. A major complication was only skin graft‐versus‐host disease (grade I). CB could be an alternate stem cell source for childhood SAA after modified preparative regimen.