ISSN: 1300-7777 E-ISSN: 1308-5263
Syngeneic peripheral blood stem cell transplantation with immunosuppression for hepatitis-associated severe aplastic anemia [Turk J Hematol]
Turk J Hematol. 2010; 27(4): 294-298 | DOI: 10.5152/tjh.2010.52  

Syngeneic peripheral blood stem cell transplantation with immunosuppression for hepatitis-associated severe aplastic anemia

Aleksandar Savic1, Bela Balint2, Ivana Urosevic1, Nebojsa Rajic1, Milena Todorovic3, Ivanka Percic1, Stevan Popovic1
1Clinic Of Hematology, Clinical Center Of Vojvodina, Novi Sad, Serbia
2Institute Of Transfusiology, Military Medical Academy, Belgrade, Serbia
3Clinic Of Hematology, Clinical Center Of Serbia, Belgrade, Serbia

Hepatitis-associated aplastic anemia occurs in up to 10% of all aplastic anemia cases. Syngeneic bone marrow transplantation is rare in patients with severe aplastic anemia and usually requires pre-transplant conditioning to provide engraftment. We report on a 29-year-old male patient with hepatitis-associated severe aplastic anemia who had a series of severe infectious conditions before transplantation, including tracheal inflammation. Life-threatening bleeding, which developed after bronchoscopy, was successfully treated with activated recombinant factor VII and platelet transfusions. Syngeneic peripheral blood stem cell transplantation using immunosuppressive treatment with antithymocyte globulin and cyclosporin A without high-dose pre-transplant conditioning was performed, followed by complete hematologic and hepatic recovery.

Keywords: Aplastic anemia, hepatitis, peripheral blood stem cell transplantation, trachea, infection, bleeding


Hepatite bağlı şiddetli aplastik anemi için immunosüpresyonla singeneik periferik kan kök hücre transplantasyonu

Aleksandar Savic1, Bela Balint2, Ivana Urosevic1, Nebojsa Rajic1, Milena Todorovic3, Ivanka Percic1, Stevan Popovic1
1Clinic Of Hematology, Clinical Center Of Vojvodina, Novi Sad, Serbia
2Institute Of Transfusiology, Military Medical Academy, Belgrade, Serbia
3Clinic Of Hematology, Clinical Center Of Serbia, Belgrade, Serbia

Hepatite bağlı aplastik anemi, tüm aplastik anemi olgularının %10’undan daha az bir oranda meydana gelir. Şiddetli aplastik anemili hastalarda singeneik kemik iliği transplantasyonu nadir olup, genellikle hibritleşmeyi sağlamak için nakil öncesi şartlandırma gerektirmektedir. Transplantasyondan önce, trakea enflamasyonu da dahil olmak üzere şiddetli enfeksiyonlar geçiren hepatite bağlı şiddetli aplastik anemili 29 yaşında erkek bir hastaya ilişkin bir rapor sunulmuştur. Bronkoskopiyi takiben gelişen yaşamı tehdit eden kanama, aktive edilmiş rekombinant faktör VII ve platelet transfüzyonlarıyla başarılı şekilde tedavi edilmiştir. Yüksek doz nakil öncesi şartlandırma olmaksızın, antitimosit globulin ve siklosporin A ile immunosüpresif tedavi yöntemiyle singeneik periferik kan kök hücre transplantasyonu gerçekleştirilmiş ve ardından tam hematolojik ve hepatik iyileşme gözlenmiştir.

Anahtar Kelimeler: Aplasti Anemi, hepatit, periferik kan kök hücre transplantasyonu, trake, enfeksiyon, kanama


Aleksandar Savic, Bela Balint, Ivana Urosevic, Nebojsa Rajic, Milena Todorovic, Ivanka Percic, Stevan Popovic. Syngeneic peripheral blood stem cell transplantation with immunosuppression for hepatitis-associated severe aplastic anemia. Turk J Hematol. 2010; 27(4): 294-298

Corresponding Author: Aleksandar Savic, Serbia


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