Allogeneic Hematopoietic Cell Transplantation for Aplastic Anemia: A Single Institution Experience Across Six Decades

Since the introduction of allogeneic bone marrow bone marrow: The soft, spongy tissue inside most bones. Blood cells are formed in the bone marrow. transplantation (BMT) for aplastic anemia aplastic anemia: (ay-PLASS-tik uh-NEE_mee-uh) A rare and serious condition in which the bone marrow fails to make enough blood cells - red blood cells, white blood cells, and platelets. The term aplastic is a Greek word meaning not to form. Anemia is a condition that happens when red blood cell count is low. Most… , major advances have included refinements in conditioning regimens, graft-versus-host disease (GVHD) graft-versus-host disease (GVHD): Also called GVHD, it is a common complication of bone marrow/stem cell transplantation. It is caused when the donor's immune cells, now in the patient, begin to see the the patient's body as foreign and mount an immune response. GVHD most commonly effects the recipient's skin, intestines, or liver… prophylaxis, high-resolution human leukocyte antigen human leukocyte antigen: (LEW-kuh-site ANT-i-jun) One of a group of proteins found on the surface of white blood cells and other cells. These antigens differ from person to person. A human leukocyte antigen test is done before a stem cell transplant to closely match a donor and a recipient. Also called HLA. (HLA) typing, pre-transplant transfusion practices, and general supportive care supportive care: Care given to improve the quality of life, or comfort, of a person with a chronic illness. Supportive care treats the symptoms rather than the underlying cause of a disease. The goal is to help the patient feel better. Patients with low blood counts may be given blood transfusions as supportive… . We present a comprehensive retrospective single-center cohort study of 607 children and adults who underwent allogeneic transplantation for aplastic anemia over six decades at a single BMT center. We highlight key temporal changes in conditioning for related donor transplants, GVHD prophylaxis, and HLA HLA: See human leukocyte antigen. matching that correspond with improved non-relapse mortality, reduced GVHD rates, and better overall survival among HLA-matched related and unrelated donor unrelated donor: A donor that is not a sibling or other familial relation of the patient (recipient). transplants. This work provides a historical perspective on the evolution of BMT for aplastic anemia for HLA-matched related and unrelated donor recipients and identifies persistent barriers to curative therapy, including patient age and donor availability. Further studies are needed to clarify the role of anti-thymocyte globulin in conditioning regimens, improve GVHD prevention and management, and expand use of alternative donors.