Combined Use of Chinese Medicine with Allogeneic Hematopoietic Stem Cell Transplantation for Severe Aplastic Anemia Patients

Objective：To determine the effect of combined treatment with Chinese medicine（CM） and allogeneic hematopoietic stem ceil transplantation（allo-HSCT） on patients with severe aplastic anemia（SAA）.Methods：Eleven patients were treated with CM plus ailo-HSCT.Nine patients received a conditioning regimen consisting of fludarabine（Flu）,anti-thymocyte globulin（pig ALG）,or anti-lymphocyte globulin（Rabbit ATG） and cyclophosphamide（CY）,and two patients received pig ALG and CY.All patients were treated with Kidney（Shen）-reinforcing,blood-activating,and stasis-removing（KBS） herbal preparation beginning at 1 week before transplantation and ending at 8 weeks after transplantation.Chimerism status was assessed by analyzing short tandem repeat（STR） polymorphisms.Results：All patients recovered hematopoietic function and none had graft failure.The median number of days required for the absolute neutrophil count（ANC） increased to 〉0.5× 10~9/L was 15 days（12-22 days） and for spontaneous platelet recovery to 〉20×10~9/L without post-transplantation transfusion was 17 days（15-27 days）.Nine patients were longterm survivors and achieved full donor chimerism.The overall cumulative incidence of acute graft versus host disease（GVHD） grades Ⅰ-Ⅱ and Ⅲ-Ⅳ was 18.2%（2/11） and 9.1%（1 /11）,respectively.The overall accumulated incidence of chronic GVHD was 27.3%and all patients had limited chronic GVHD.At a median follow-up time of 32 months（range：12-97 months）,9 patients were still alive.The estimated 5-year overall survival（OS） rate was 81.8%.The incidence of treatment-related mortality,2-year post-transplantation,was 18.2%.Two patients died from GVHD after transplantation.Conclusion：Treatment with the KBS formulation may reduce the rate of graft failure and treatmentrelated mortality and improve the rate of OS in SAA patients with allo-HSCT.

A comparative study of unrelated donor and matched-sibling donor allogeneic hematopoietic stem cell transplantation in children and adolescents with acquired severe aplastic anemia

Objective To evaluate the efficacy of unrelated do-nor allogeneic hematopoietic stem cell transplantation(URD allo-HSCT).for children and adolescents with severe aplastic anemia(SAA).Methods Clinical data of34 SAA children and adolescents undergoing allo-HSCT were retrospectively analyzed from October 2001 to October 2015.According to the source of donor,the