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.

  • Review
  • Published:

Standard treatment of acquired SAA in adult patients 18–40 years old with an HLA-identical sibling donor

Bone Marrow Transplantation volume 48, pages 178–179 (2013)Cite this article

Subjects

Abstract

Matched related donor allo-SCT is the treatment of choice for patients with severe aplastic anemia (SAA) younger than 40 years of age. The standard conditioning regimen for such patients is cyclophosphamide with antithymocyte globulin. Unmanipulated BM is the best stem cell source for aplastic anemia patients going for SCT. Post-transplant GVHD prophylaxis with cyclosporine should be continued for 1 year. Early graft failure is rare but potentially life-threatening complication of SCT that can be managed with salvage SCT using more intense conditioning regimen.

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

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

Similar content being viewed by others

References

  1. Armand P, Antin JH . Allogeneic stem cell transplantation for aplastic anemia. Biol Blood Marrow Transplant 2007; 13: 505–516.

    Article  CAS  PubMed  Google Scholar 

  2. Bacigalupo A, Brand R, Oneto R, Bruno B, Socié G, Passweg J et al. Treatment of acquired severe aplastic anemia: Bone marrow transplantation compared with immunosuppressive therapy – The European Group for Blood and Marrow Transplantation experience. Semin Hematol 2000; 37: 69–80.

    Article  CAS  PubMed  Google Scholar 

  3. Storb R, Etzioni R, Anasetti C, Appelbaum FR, Buckner CD, Bensinger W et al. Cyclophosphamide combined with antithymocyte globulin in preparation for allogeneic marrow transplants in patients with aplastic anemia. Blood 1994; 84: 941–949.

    CAS  PubMed  Google Scholar 

  4. Storb R, Leisenring W, Anasetti C, Appelbaum FR, Buckner CD, Bensinger WI et al. Long-term follow-up of allogeneic marrow transplants in patients with aplastic anemia conditioned by cyclophosphamide combined with antithymocyte globulin (letter). Blood 1997; 89: 3890–3891.

    CAS  PubMed  Google Scholar 

  5. Champlin RE, Perez WS, Passweg JR, Klein JP, Camitta BM, Gluckman E et al. Bone marrow transplantation for severe aplastic anemia: a randomized controlled study of conditioning regimens. Blood 2007; 109: 4582–4585.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Maury S, Bacigalupo A, Anderlini P, Aljurf M, Marsh J, Socié G et al. Improved outcome of patients older than 30 years receiving HLA-identical sibling hematopoietic stem cell transplantation for severe acquired aplastic anemia using fludarabine-based conditioning: a comparison with conventional conditioning regimen. Haematologica 2009; 94: 1312–1315.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Al-Zahrani H, Nassar A, Al-Mohareb F, Al-Sharif F, Mohamed S, Al-Anazi K et al. Fludarabine-based conditioning chemotherapy for allogeneic hematopoietic stem cell transplantation in acquired severe aplastic anemia. Biol Blood Marrow Transplant 2011; 17: 717–722.

    Article  CAS  PubMed  Google Scholar 

  8. Marsh JC, Gupta V, Lim Z, Ho AY, Ireland RM, Hayden J et al. Alemtuzumab with fludarabine and cyclophosphamide reduces chronic graft-versus-host disease after allogeneic stem cell transplantation for acquired aplastic anemia. Blood 2011; 118: 2351–2357.

    Article  CAS  PubMed  Google Scholar 

  9. Schrezenmeier H, Passweg JR, Marsh JC, Bacigalupo A, Bredeson CN, Bullorsky E et al. Worse outcome and more chronic GVHD with peripheral blood progenitor cells than bone marrow in HLA-matched sibling donor transplants for young patients with severe acquired aplastic anemia. Blood 2007; 110: 1397–1400.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Bacigalupo A, Socié G, Schrezenmeier H, Tichelli A, Locasciulli A, Fuehrer M et al. Bone marrow versus peripheral blood as the stem cell source for sibling transplants in acquired aplastic anemia: survival advantage for bone marrow in all age groups. Haematologica 2012; 97: 1142–1148.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Locatelli F, Bruno B, Zecca M, Van-Lint MT, McCann S, Arcese W et al. Cyclosporin A and short-term methotrexate versus cyclosporin A as graft versus host disease prophylaxis in patients with severe aplastic anemia given allogeneic bone marrow transplantation from an HLA-identical sibling: results of a GITMO/EBMT randomized trial. Blood 2000; 96: 1690–1697.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Adult HSCT Program, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia

    M Aljurf & H Al-Zahrani

  2. Department of Hematology, Ospedale San Martino, Genova, Italy

    M T Van Lint

  3. Klinik Hämatologie, Bereich Innere Medizin, Universitätsspital Basel, Basel, Switzerland

    J R Passweg

Authors
  1. M Aljurf
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. H Al-Zahrani
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M T Van Lint
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J R Passweg
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M Aljurf.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Aljurf, M., Al-Zahrani, H., Van Lint, M. et al. Standard treatment of acquired SAA in adult patients 18–40 years old with an HLA-identical sibling donor. Bone Marrow Transplant 48, 178–179 (2013). https://doi.org/10.1038/bmt.2012.223

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/bmt.2012.223

Keywords

This article is cited by

Search

Advanced search

Quick links