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First-line haploidentical stem cell transplantation in children and adolescents with severe aplastic anemia using mobilized peripheral blood as source of CD34+: Single-institutional experience in a transplant center from northeast Mexico

Authors :
Severiano Baltazar-Arellano
Roberto Hernandez
Rosa E. De Leon
Adriana Sandoval
Gerardo Martinez-Pozos
Guillermo Sotomayor-Duque
Guadalupe Gonzalez-Villarreal
Myrna Pequeño-Luevano
Andrés Ortega
Source :
Pediatric transplantationREFERENCES. 25(7)
Publication Year :
2021

Abstract

Introduction The only curative treatment for severe aplastic anemia in children is an allogeneic stem cell transplant; however, few patients have a matched related or unrelated donor. Haploidentical stem cell transplantation (haplo-SCT) using bone marrow (BM) and peripheral blood stem cells (PBSC) has been recently described as effective and safe. In this study, we retrospectively report the outcome of twelve pediatric patients who underwent haplo-SCT using only PBSC. Methods The conditioning regimen consisted on rabbit anti-thymocyte globulin (r-ATG) 2.5 mg/kg/d on days -7, -6,-5, and -4, and cyclophosphamide (Cy) 50 mg/kg/d on days -3 and -2. We used Cy 50 mg/kg/d on days +3 and +4, tacrolimus and mycophenolic acid as graft versus host disease (GVHD) prophylaxis. Results The median follow-up was 1,099 days (45-1258 days). The overall survival rate up-to-date is 83.3%. In 10 of the 12 patients, a sustained graft was achieved. None of the patients had acute or chronic GVHD. Conclusions Haplo-SCT could be established as a first-line treatment when there is no matched related or unrelated donor. According to this short sample and previous reports, PBSC are a feasible option effectively used as the sole source of stem cells. Additionally, post-transplant cyclophosphamide remains a good strategy for GVHD prevention.

Details

ISSN :
13993046
Volume :
25
Issue :
7
Database :
OpenAIRE
Journal :
Pediatric transplantationREFERENCES
Accession number :
edsair.doi.dedup.....3a27319bb7962be85fb4e8fbff4fffb8