Journal of Clinical Cases

Related Allogeneic Hematopoietic Stem Cell Transplantation For Very Severe Aplastic Anemia With Active Pulmonary Fungal Infection: Case Report

Ying He^*1, Xin-miao Wang, Shan Zhang, Si-han Lai, Guangcui He, Ye-cheng Li, Ying Han, Lei Ma,Yan Deng, Fang Liu and Hai Yi^*

Department of Pulmonary Fungal, China.

Corresponding Author: Ying He

ABSTRACT

Background: Heavy aplastic anemia and very heavy aplastic anemia (SAA and vSAA) is a potentially deadly disease due to bone marrow failure, Immunosuppressive therapy (IST) and allogeneic hematopoietic stem cell transplantation (allo-HSCT) are the main treatments [1,2]. Infection is the main cause of death in AA patients [3], and it is also a risk factor affecting the outcome of allo-HSCT Adequate anti-infection treatment is extrahematopoietic stem cell transplantation important for allo-HSCT. During severe periods of active infection, patients develop further fatal neutropenia, transfusion dependence, and persistent fever after broadspectrum potent anti-infective therapy, and urgent allo-HSCT is needed for faster peripheral blood imaging recovery and infection control. Given that HLA-matched sibling donors (MSDs) and unrelated donors (URDs) are difficult to obtain in the short term, related haploid compatible donors (HID-HSCT) [1] and umbilical cord blood transplantation (UCBT) can be used when IST treatment fails, especially in emergency situations where no MSDS or URDs are available. Patients who undergo umbilical cord blood transplantation UCBT have to face the challenges of delayed engraftment, risk of graft failure, increased transplant‐related mortality (TRM) and infection [3], so the relative HID-HSCT is preferred. Related allo-HSCT , including MSD and relative HID-HSCT, promote rapid recovery of neutrophils and are highly effective in controlling infection. Therefore, the related allo-HSCT may be a potentially effective treatment for patients with vSAA combined with active pulmonary fungal infection.

Case presentation: In this report, two young patients diagnosed with “vSAA” after 1 month with active pulmonary fungal infection were treated with related alloHSCT, the peripheral blood images gradually returned to normal, and the lesions of pulmonary infection gradually improved and absorbed.

Conclusion: Patients diagnosed vSAA with active pulmonary fungal infection are expected to be cured by the relative allo-HSCT and may achieve longterm disease-free survival.

Key worlds:Related allo-HSCT; vSAA; Active pulmonary fungal infection

Citation:

Dr.Ying He ,Related Allogeneic Hematopoietic Stem Cell Transplantation For Very Severe Aplastic Anemia With Active Pulmonary Fungal Infection: Case Report. Journal of Clinical Cases 2023.