ISSN 1866-8836
Клеточная терапия и трансплантация

NM-01. Haploidentical stem cell transplantation for aplastic anemia patients: one-center experience

Zalina T. Fidarova, Dmitry K. Bessmertnyy, Anton V. Luchkin, Mikhail Y. Drokov, Anastasia V. Abramova, Artur V. Bulgakov, Vera V. Troitskaya, Larisa A. Kuzmina, Elena A. Mikhailova

National Medical Research Center for Hematology, Moscow, Russia


Contact: Dr. Dmitry K. Bessmertnyy, e-mail: dmitry_bessmertnyy@mail.ru

doi 10.18620/ctt-1866-8836-2023-12-3-1-176

Summary

Modern guidelines for acquired aplastic anemia (AA) are widely recognized and reproducible. However, critical conditions in disease onset or refractoriness can’t be managed by using standard protocols. In such cases decision should be made within a short time period. A great progress in application of haplo-HSCT over the past decade argues for its usage when treating the AA patients. Our aim was to analyze results of HSCT from related haploidentical donor for patients with AA at the onset, upon refractory course and disease relapse.

Materials and methods

We performed three allo-HSCT from haploidentical donor for patients with AA at the Department of Hemoblastosis, Chemotherapy and Bone Marrow Failure, and HSCT unit at the National Medical Research Center for Hematology (Moscow, Russia) from 2020 until 2023. Clinical characteristics of the patients are presented in Table 1. All three patients had different stages of the disease course at the time of allo-HSCT, i.e., de novo AA, relapse of AA and refractory AA.

Results

Two patients are alive at the time of analysis. One patient died (№3) due to progression of infectious diseases caused by graft rejection. The median of neutrophil recovery was 16 (15-28) days, what helped to control the course of critical infectious complications. As far as we can state, inclusion of rabbit ATG into conditioning regime is crucial for preventing graft rejection.

Conclusion

Haploidentical SCT from related donor may be considered a salvage therapy for patients with AA with severe infectious complications on any stage of the disease.

Keywords

Aplastic anemia, hematopoietic stem cell transplantation, haploidentical donor.


Table 1. Characteristics of the patients

Fidarova-tab01.jpg

SAA – severe aplastic anemia;rATG – rabbit anti-thymocyte globulin; hATG – horse anti-thymocyte globulin; Flu – fludarabine; Tro – treosufan; G-CSF – granulocyte colony stimulating factor; PtCy – post transplantational cyclosporine; ALF – acute lung failure.

Supplement 12-3
09/30/2023

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doi 10.18620/ctt-1866-8836-2023-12-3-1-176

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