Unrelated donor cord blood transplantation for childhood severe aplastic anemia after a modified conditioning.

Abstract	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 x 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.
Authors	Shouichi Ohga, Kiyomi Ichino, Kazuna Goto, Sagano Hattori, Akihiko Nomura, Hidetoshi Takada, Katsumasa Nakamura, Toshiro Hara
Journal	Pediatric transplantation (Pediatr Transplant) Vol. 10 Issue 4 Pg. 497-500 (Jun 2006) ISSN: 1397-3142 [Print] Denmark
PMID	16712610 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)
Chemical References	Glucocorticoids Myeloablative Agonists Prednisolone Vidarabine Melphalan
Topics	Anemia, Aplastic (therapy) Child Cord Blood Stem Cell Transplantation (methods) Female Follow-Up Studies Glucocorticoids (administration & dosage) Graft vs Host Disease (drug therapy) Histocompatibility Histocompatibility Testing Humans Melphalan (administration & dosage) Myeloablative Agonists (administration & dosage) Prednisolone (administration & dosage) Severity of Illness Index Time Factors Transplantation Chimera Transplantation Conditioning Treatment Outcome Vidarabine (administration & dosage, analogs & derivatives) Whole-Body Irradiation (methods)

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