Shifting Paradigms: The Case of Autologous Reconstitution after an Upfront Matched Unrelated Hematopoietic Cell Transplantation for Severe Acquired Aplastic Anemia in a Child.
Fiche publication
Date publication
octobre 2023
Journal
Medicina (Kaunas, Lithuania)
Auteurs
Membres identifiés du Cancéropôle Est :
Dr POCHON Cécile, Dr PAGLIUCA Simona
Tous les auteurs :
Pochon C, Lubnau M, Pagliuca S
Lien Pubmed
Résumé
During the last few years, the therapeutic landscape of idiopathic aplastic anemia (IAA) has been profoundly revolutionized by the increased use of alternative transplant procedures, such that today hematopoietic cell transplantation (HCT) from a matched unrelated donor (MUD) has been suggested as a possible first line strategy in pediatric patients with severe IAA, in the absence of a matched related donor. However, in this particular context, outcomes and early and long-term toxicities remain to be determined, as compared to non-transplant procedures. While prospective trials are ongoing, we report here the case of a 12-year-old boy with IAA, receiving an upfront bone marrow HCT from a MUD, who experienced early graft rejection associated with autologous hematological recovery, which could induce remission of his hemopathy. This case offers the opportunity to discuss the challenges associated with these new transplant paradigms and provides a brief review of the literature regarding the issue of autologous recoveries after allogeneic HCT in IAA.
Mots clés
MUD HCT, autologous reconstitution, graft failure, severe aplastic anemia
Référence
Medicina (Kaunas). 2023 10 24;59(11):