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KMID : 0387820160230010057
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Clinical Pediatric Hematology-Oncology
2016 Volume.23 No. 1 p.57 ~ p.60
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Successful Allogeneic Hematopoietic Stem Cell Transplantation for a Patient with Very Severe Aplastic Anemia During Active Invasive Fungal Infection
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Seo Eu-Ri
Kim Hye-Ri
Ko Kyung-Nam
Im Ho-Joon
Seo Jong-Jin
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Abstract
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Allogeneic hematopoietic stem cell transplantation (HSCT) may not be considered fea-sible in a patient with active fungal infection due to transplant-related mortality. We re-port a case of HSCT performed on a 6-month-old girl, who was diagnosed with very severe aplastic anemia (vSAA) at the age of 2 months, during active invasive pulmonary aspergillosis (IPA). Despite receiving continuous antifungal treatment and multiple gran-ulocyte infusions, her IPA was aggravated. She underwent allogeneic HSCT from a matched sibling donor using conditioning regimen of fludarabine, reduced dose of cyclo-phosphamide, and anti-thymocyte globulin (ATG) during IPA. After neutrophil engraft-ment, fever subsided and IPA improved. She was continued on voriconazole for 7 months after HSCT. She is alive with normal hematopoiesis 4 years post-transplant. Our report suggests that allogeneic HSCT using conditioning regimen of fludarabine, reduced dose of cyclophosphamide, and ATG can be a feasible option for the patients with vSAA even during active fungal infection.
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KEYWORD
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Aplastic anemia, Hematopoietic stem cell transplantation, Invasive pulmo-nary aspergillosis
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