title: Successful tandem transplant in a young aplastic anemia patient from a small-weight 11-month-old sibling donor.
abstract: Five years five month old male child diagnosed with aplastic anemia required blood and platelet support regularly. He was advised bone marrow transplant (BMT) and had 6/6 match with a younger sibling (11 months old). He was admitted for planned BMT and was put on preparatory regimen five days prior to BMT. GCSF-primed bone marrow (BM) harvest was done from the donor, but the harvest was insufficient (1.05 × 10^6 /kg) and target dose of 4 million stem cells per kg could not be achieved. The BM harvest was infused into the patient and a repeat BM harvest was contemplated on next day. After careful evaluation of risks and benefits to the patient and the young donor, a decision to do a peripheral blood stem cell (PBSC) harvest was taken. The apheresis kit was blood primed to preclude possible hemodynamic imbalance in the donor considering low weight and young age. The entire harvest procedure (321 minutes) was uneventful with the donor remaining stable throughout. A dose of 2.40 million per kg of CD34+ cells was harvested and infused. Thus, a total dose of 3.45 million (1.05 BM and 2.4 PBSC) per kg was infused into the patient. Neutrophil and platelet engraftments and donor chimerism were achieved successfully with tandem BM-PBSC infusion and the patient continues to be disease free till 180 days follow up. This is possibly first published Indian report on BM-PBSC tandem transplant suggesting safety of PBSC harvests in small-weight young-age donor.
authors.affiliation: Transfusion Medicine, Medanta-The Medicity Hospital, Sector 38, Gurgaon, Haryana 122001, India.
authors.forename: Dinesh
authors.initials: D
authors.lastname: Arora
authors.affiliation: Transfusion Medicine, Medanta-The Medicity Hospital, Sector 38, Gurgaon, Haryana 122001, India. Electronic address: aseemtwr@yahoo.co.in.
authors.forename: Aseem Kumar
authors.initials: AK
authors.lastname: Tiwari
authors.affiliation: Transfusion Medicine, Medanta-The Medicity Hospital, Sector 38, Gurgaon, Haryana 122001, India.
authors.forename: Ravi C
authors.initials: RC
authors.lastname: Dara
authors.affiliation: Transfusion Medicine, Medanta-The Medicity Hospital, Sector 38, Gurgaon, Haryana 122001, India.
authors.forename: Ruchira
authors.initials: R
authors.lastname: Misra
authors.affiliation: Transfusion Medicine, Medanta-The Medicity Hospital, Sector 38, Gurgaon, Haryana 122001, India.
authors.forename: Geet
authors.initials: G
authors.lastname: Aggarwal
authors.affiliation: Transfusion Medicine, Medanta-The Medicity Hospital, Sector 38, Gurgaon, Haryana 122001, India.
authors.forename: Devi Prasad
authors.initials: DP
authors.lastname: Acharya
authors.affiliation: Transfusion Medicine, Medanta-The Medicity Hospital, Sector 38, Gurgaon, Haryana 122001, India.
authors.forename: Vimarsh
authors.initials: V
authors.lastname: Raina
mesh_terms: D000741:Anemia, Aplastic / Q000628:therapy*; D001835:Body Weight; D016026:Bone Marrow Transplantation; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D036102:Peripheral Blood Stem Cell Transplantation; D035781:Siblings; D014019:Tissue Donors; D016896:Treatment Outcome
keywords: GCSF-primed bone-marrow harvest; Hematopoietic stem cell transplant; Tandem harvest