Allogeneic Hematopoietic Stem Cell Transplantation for Patients with Severe Aplastic Anemia Following Nonmyeloablative Conditioning Using 200-cGy Total Body Irradiation and Fludarabine

In patients with aplastic anemia (AA), allogeneic stem cell transplantation (ASCT) is the treatment of choice for younger patients with HLA-matched siblings. In patients older than 40 years, transplant-related mortality approaches 50% and survival does not differ between patients who receive ASCT and those who receive immunosuppressive therapy [1]. In this age group, immunosuppressive therapy has been advocated as upfront therapy, with ASCT offered only for failed immunosuppressive therapy or relapse [2].