[The efficacy and safety of mismatched hematopoietic stem cell transplantation for treatment of severe aplastic anemia].

OBJECTIVE

To study the efficacy and safety of human leukocyte antigen (HLA) mismatched hematopoietic stem cell transplantation (HSCT) on severe aplastic anemia (SAA).

METHODS

From January 2006 to May 2010, 17 patients received mismatched HSCT. HLA antigens were 3-loci-mismatched in 9 patients, 2-loci-mismatched in 8. All patients received recombinant human granulocyte colony-stimulating factor (rhG-CSF) primed bone marrow cells plus peripheral blood stem cells after modified busulfan/cyclophosphamide + antithymocyte immunoglobulin (BU/CY + ATG) conditioning regimen.

RESULTS

All patients achieved full donor type engraftment. Grade III-IV graft versus host disease (GVHD) occurred in 3 patients and extensive chronic GVHD in 1. With a median following-up time of 285 (60 - 1670) d, 11 patients were alive, 9 of them had normal blood counts and the other 2 were blood transfusion independent. Six patients died of transplant-related complications.

CONCLUSION

Mismatched HSCT is a feasible and safe option for SAA patients without sibling identical donors.