On January 17, 2023, a male patient with severe aplastic anemia, surnamed Ma, was successfully treated with umbilical cord blood transplantation, properly recovered and discharged from the First Affiliated Hospital of Xi’an Jiaotong University (XJTU). This is the first case of umbilical cord blood transplantation for successful treatment of adult severe aplastic anemia in northwest China, which signifies the beginning of a new chapter in umbilical cord blood transplantation in our hospital.
Aplastic anemia is a bone marrow failure disease. Allogeneic hematopoietic stem cell transplantation is the optimal treatment for this disease.
In September, 2022, the patient was admitted to our hospital due to fatigue complicated with skin ecchymosis. He was diagnosed with severe aplastic anemia via bone marrow puncture and alternative examinations. However, a matched donor was not available and a matched donor could not be identified in China Marrow Donor Program. Consequently, Professor Zhang Mei from Department of Hematology proposed umbilical cord blood transplantation. Previously, our hospital only performed umbilical cord blood transplantation for a child with leukemia. Relevant clinical experience was lacking in aplastic anemia. The transplantation team sent a matching inquiry to Shandong Cord Blood Bank, and finally found matched umbilical cord blood. The stem cell transplantation team from Department of Hematology decided to perform umbilical cord blood transplantation for the patient.
The transplantation team delivered multiple consultations regarding the disease condition, invited domestic prestigious experts in the field of umbilical cord blood transplantation to provide guidance, and carefully formulated treatment regimens, including use and dosage of pretreatment drugs, selection and infusion method of umbilical cord blood, use of immunosuppressants and other auxiliary methods to assist transplantation, and prevention and treatment plans for complications,etc. On November 22, 2022, the patient was transferred to operation room for umbilical cord blood transplantation, and successively experienced multiple complications, such asPseudomonas aeruginosainfection,Enterococcus faecalisbacteremia, skin and soft tissue infection and grade IV oral mucositis,etc. After attentive diagnosis, treatment and nursing care by the transplantation team, the patient overcame multiple barriers, the granulocyte system was reconstructed on postoperative 14 days, the erythroid system was reconstructed on 20 days, the platelet was reconstructed on 28 days, and he was discharged after gradual recovery.
The success of umbilical cord blood transplantation in this patient signifies that our hospital achieves further improvement and breakthrough in hematopoietic stem cell transplantation, providing a novel transplantation approach for patients without matched donors.
