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Case Reports in Medicine
Volume 2014 (2014), Article ID 576373, 5 pages
http://dx.doi.org/10.1155/2014/576373
Case Report

Dynamics of Graft Function Measured by DNA-Technology in a Patient with Severe Aplastic Anemia and Repeated Stem Cell Transplantation

1Department of Pediatrics/Pediatric Hematology and Oncology Unit, Medical University Plovdiv, 15A Vasil Aprilov Boulevard, 4000 Plovdiv, Bulgaria
2Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University Graz, Auenbruggerplatz 34/2, 8036 Graz, Austria

Received 28 November 2013; Accepted 27 January 2014; Published 4 March 2014

Academic Editor: Yasuhiko Sugawara

Copyright © 2014 Anna Karastaneva et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Although bone marrow transplantation (BMT) from an HLA identical sibling is considered as treatment of choice in pediatric patients with severe aplastic anemia (SAA), a significant number of them experience graft failure (GF) after BMT. We report a case of an 8-year-old male patient with SAA who presented with a complicated posttransplant course due to parvovirus B19 infection and GF. A subsequent attempt to support the graft by antithymocyte globulin (ATG) and a peripheral stem cell boost resulted in transitory autologous recovery of hematopoiesis followed by mixed chimerism, supported by donor lymphocyte infusions (DLIs) and finally graft rejection with relapse of SAA. Permanent complete chimerism was achieved by a second BMT. Dynamics of graft function, measured by a single nucleotide polymorphism (SNPs) analysis, are discussed.