Modern Medical Miracle: Matched Unrelated Donor Hematopoietic Stem Cell Transplant After Aplastic Anemia

Aplastic anemia is a hematological disease with deadly complications related to pancytopenia if not treated in a timely manner. First-line treatment consists of immunosuppressive therapy or matched sibling donor (MSD) hematopoietic stem cell transplant. Step up treatment involves a matched unrelated donor (MUD) hematopoietic stem cell transplant (HSCT) alongside immunosuppressant conditioning. However, recent research suggests that there is improved success of MUD HSCT for severe aplastic anemia compared to immunosuppressive therapy. We present a case of an 18-year-old who was diagnosed with severe aplastic anemia who received numerous immunosuppressive therapy regimens prior to obtaining a MUD HSCT. Over a year after bone marrow transplant, the patient is doing well with no signs of rejection. This case creates an argument for the use of upfront MUD HSCT as a curative treatment for acquired aplastic anemia rather than initial treatment with immunosuppressive agents.