Purpose: Evaluation of peripheral blood hematopoietic stem cell transplation for seVere aplastic anemia on the National Institue of Hematology and Bood Transfusion. Subjects and Methods: . Between November 2010 to December 2011, 4 patients with severe aplastic anemia, (40 years old, HLA matched donors or = 5/6 aliens) underwent allogeneic HCT on the National Institue of Hematology and Bood Transfusion. Stem cells have ben mobilized, collected and preserved from peripheral blood donors. The transplant conditioning consisted of CY (120mg/kg) and fludarabine (125mg/m2) without ATG. CSA combined with methotrexate was used as GVHD prophylaxis. Monitoring and comprehensive care are in level 1. Definitions: Neutrophil engraftment was defined to have occurred on the first of 3 consecutive days during which the ANC was 0.5 G/l, and to have platelet engraftment occurred on the first 3 consecutive days with a PLT counts 20 G/L without transfusion support. Graft failure: ANC not achieve 0.5 G/L after post-transplant 30 days. Graft rejection: reduced blood cell counts after the initial engraftment. Results: Technical process: mobilization, collection and preservation of stem cells from peripheral blood donors was administered effectively and has reached a high dose: CD34+ was 7.17-14.92 x 106 per kg patient waight (average 11.2). Complications: aGVHD and cGVHD grade I was seen in one patient (25 percent)
graft rejection was seen in one patient (25 percent). Result: engraftment was observed in all four patients, success was seen in 3 patients. Conclusion: This was the first study on hematopoietic stem cell transplantation using peripheral stem cells to treat severe aplastic anemia in Vietnam. The number of patient is small - 04 but the the results of study was very encouraging . The authors were able to set up the conditioning regimen consisted of CY and Fludarabin
standard operation procedure of mobilization, collection and preservation at 2-8oC under 72 hours of stem cells from peripheral blood donors. Transplantation results was encouraging with a high rate of engraftment of 100 percent and free - disease survival was 75 percent. The protocol of hematopoietic stem cell transplation (HCT) for severe aplastic anemia has been completed, safe and high effectivelly. The expenditure of one case bone marrow was around 15,000 USD, lower than it done in others Asian countries and on the world.