Successful management with urgent haploidentical-peripheral blood stem cell transplantation for a patient with severe aplastic anaemia who developed disseminated fungal infection following immunosuppressive therapy

EJHaem Pub Date : 2024-07-17 DOI:10.1002/jha2.917
Norihito Ikenobe, Kentaro Fujimori, Yoshihiro Gocho, Shota Myojin, Masaki Yamada, Kenichi Imadome, Mikiko Miyasaka, Osamu Miyazaki, Akihiro Yoneda, Shotaro Matsumoto, Satoshi Nakagawa, Takao Deguchi, Akihiro Iguchi, Daisuke Tomizawa, Chikara Ogimi, Kimikazu Matsumoto, Hirotoshi Sakaguchi
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Abstract

Urgent haploidentical haematopoietic cell transplantation may be considered in cases of severe aplastic anaemia (SAA) without a human leukocyte antigen-matched donor and suffering from severe infection. However, deciding on allogeneic transplantation in the setting of active systemic infection is challenging due to poor outcomes. This report presents a case of disseminated Magnusiomyces capitatus infection in a 5-year-old male who underwent immunosuppressive therapy for hepatitis-associated SAA. To address the critical situation, granulocyte transfusion was promptly administered from the patient's mother, followed by unmanipulated haploidentical peripheral blood stem cell transplantation from the patient's father with posttransplant cyclophosphamide, ultimately resulting in successful rescue.

Abstract Image

对一名在接受免疫抑制治疗后出现播散性真菌感染的重型再生障碍性贫血患者进行紧急单倍体外周血干细胞移植,并取得成功
如果重型再生障碍性贫血(SAA)患者没有人类白细胞抗原匹配的供体,又患有严重感染,可以考虑紧急进行单倍体造血细胞移植。然而,由于疗效不佳,在全身感染活跃的情况下决定是否进行异基因移植极具挑战性。本报告介绍了一例因肝炎相关性 SAA 而接受免疫抑制治疗的 5 岁男性患者的帽状木兰霉菌播散性感染病例。为应对危急情况,患者母亲及时输注了粒细胞,随后患者父亲进行了非人工单倍体外周血干细胞移植,并在移植后使用环磷酰胺,最终成功救治。
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