Unexpected unrelated umbilical cord blood stem cell engraft in two patients with severe aplastic anemia that received immunosuppressive treatment: A case report and literature review

Abstract

Severe aplastic anemia (SAA) is a life-threatening bone marrow disorder. Bone marrow transplantation is the primary therapy for SAA; however, its efficacy is limited by numerous factors, including lack of histocompatible sibling donor, patient age and graft-versus-host-disease (GVHD) following transplantation. Immunosuppressive treatment (IST) is the first procedure developed for patients without a sibling donor. Our previous study reported that patients administered enhanced IST, in addition to a regime of unrelated umbilical cord blood (UCB) transfusion, exhibited higher efficiency and a reduced rate of relapse. Therefore, the present study reported the cases of 2 patients that received enhanced IST plus unrelated UCB transfusion. These patients exhibited complete hematological recovery with an increased rate of mixed chimerism and demonstrated no signs of GVHD or relapse during the 2-year follow-up period. Thus, enhanced immunosuppressive treatment (low-dose cyclophosphamide and antithymocyte globulin) combined with UCB transfusion may be an effective treatment for patients with SAA.