title: [Female case of successful engraftment after PBSCT from her HLA-haploidentical son for severe aplastic anemia during maintenance peritoneal dialysis].
abstract: A 51-year-old woman developed very severe aplastic anemia complicated by chronic renal failure. She underwent ATG therapy, resulting in a transient effect. Thereafter, renal insufficiency progressed, followed by the induction of CAPD therapy. Although rabbit ATG (rATG) was administered as the next immunotherapy for aplastic anemia, pancytopenia persisted and she experienced repeated episodes of severe infection including MRSA and fungal infections. She was transplanted with peripheral blood stem cells from her HLA-haploidentical son after a reduced-intensity conditioning regimen that included cyclophosphamide (three days of 30 mg/kg), fludarabine (two days of 20 mg/m(2)) and rATG (three days of 2.5 mg/kg). FK506 (0.03 mg/kg/24H) was administered for the prophylaxis of GVHD. Prompt trilineage engraftment occurred, resulting in the improvement of infections. Three months after grafting, she succumbed to cerebrovascular disease, although there was no apparent GVHD and she had remained well with stable hematopoiesis.
authors.affiliation: Department of Internal Medicine, PL General Hospital.
authors.forename: Shinya
authors.initials: S
authors.lastname: Rai
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Matsuda
authors.forename: Nozomi
authors.initials: N
authors.lastname: Yamairi
authors.forename: Takao
authors.initials: T
authors.lastname: Kazuta
authors.forename: Takayuki
authors.initials: T
authors.lastname: Iwanaga
authors.forename: Masato
authors.initials: M
authors.lastname: Aoyama
authors.forename: Masaki
authors.initials: M
authors.lastname: Kawamura
authors.forename: Shigeo
authors.initials: S
authors.lastname: Hashimoto
authors.forename: Nobuo
authors.initials: N
authors.lastname: Itagaki
mesh_terms: D000741:Anemia, Aplastic / Q000628:therapy*; D000818:Animals; D000961:Antilymphocyte Serum / Q000008:administration & dosage; D003520:Cyclophosphamide / Q000008:administration & dosage; D005260:Female; D006085:Graft Survival; D006680:HLA Antigens / Q000235:genetics*; D006238:Haploidy; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D008875:Middle Aged; D009679:Nuclear Family; D036102:Peripheral Blood Stem Cell Transplantation; D010531:Peritoneal Dialysis, Continuous Ambulatory; D011817:Rabbits; D012720:Severity of Illness Index; D016559:Tacrolimus / Q000008:administration & dosage; D019172:Transplantation Conditioning; D014740:Vidarabine / Q000008:administration & dosage / Q000031:analogs & derivatives
chemical_list: D000961:Antilymphocyte Serum; D006680:HLA Antigens; D007166:Immunosuppressive Agents; D003520:Cyclophosphamide; D014740:Vidarabine; C024352:fludarabine; D016559:Tacrolimus